Alternative Medicine: Weapons of Influence

July 21, 2009 at 3:11 pm (Alternative Medicine) (, , , , )

In 2001, the fourth edition of a book titled Influence: Science and Practice written by Robert Cialdini was published. The book explained several mental shortcuts that we use – and how they can be used to persuade or to influence people.

These shortcuts, which are all potential ‘weapons of influence’, are as follows: reciprocation; commitment and consistency; social proof; liking; authority; and scarcity.

Social Proof

The front of my copy of Cialdini’s book points out that over a quarter of a million copies of the book had been sold. This made use of the principle of social proof – we are liable to copy our peers. When a supplement salesman or someone offering homeopathic remedies claims that they take these products themselves, I wonder if it is possible that they may be using a form of social proof in order to help persuade you to purchase their wares. Patrick Holford regularly tells his audience that he follows the advice he gives them and has said in an interview with the Irish Times that “I think people are motivated to follow my advice because I explain the logic of it and I embody it” (which, I guess, may also relate to his “radiating flawlessness” – according to an interview in the Guardian). Perhaps a better example is the tendency to point out how popular their products are – homeopaths like to claim that homeopathy is popular (e.g., the BHA – “Homeopathy popular with patients in New Zealand”) or that it is/was popular specifically with celebrities (e.g., Dana Ullman – whose book on Famous People and Cultural Heroes Who Chose Homeopathy was covered by Andy Lewis of the Quackometer blog). Defence: Cialdini writes that “our best defense against these disadvantages is to recognize when the data are in error”, and points out that (1) we assume that if a lot of people are doing the same thing they must know something that we don’t and (2) a crowd may frequently be mistaken – they may not be acting on the basis of superior information and may even themselves be reacting to social proof. Just because something (say, homeopathy) is popular we should not assume that it works.

Liking

Cialdini lists several headings in the contents page for the Liking chapter – including the sub-headings physical attractiveness, similarity, and compliments. Seeing physical attractiveness listed here may remind some readers of the ‘halo effect’ – the halo effect refers to cases where “one positive characteristic dominates the way that person is viewed by others”, as Cialdini describes it. One study (Stewart, 1980) found that attractive defendants were less likely to receive a prison sentence (they were, apparently, twice as likely to avoid jail as unattractive defendants). While I doubt that being attractive is the sole reason that people proposing or defending ideas that are not supported by evidence are often vigorously defended by supporters and widely promoted by the media, it may well play a part. Patrick Holford is hardly monstrously ugly, while Andrew Wakefield was famously described by one journalist as “a handsome, glossy-haired hero to families of autistic children“. Incidentally, Patrick Holford was once interviewed by Lucy Mayhew of the Guardian: “Whether you see the signatory picture in one of his 26 books or on the label of one of his many supplement products, Patrick Holford, health spokesman and founder of the Institute of Optimum Nutrition, radiates flawlessness”. Holford is also described in this interview as being “immediately pleasant and engaging” (Irish Times). Defence: we need to be aware that undue liking has been produced. Cialdini writes that “we have to be sensitive to […] the feeling that we have come to like the practitioner more quickly or more deeply than we could have expected”.

Authority

Cialdini begins the chapter on authority by referring to Stanley Milgram’s experiment that found people were willing to administer what they believed to be 400 volt shocks. Cialdini tells us that Milgram claimed that the reason people were willing to administer these shocks had a lot to do with the fact that they (we) have a deep-seated sense of duty to authority. Reading the CV of ex-Professor Patrick Holford or Gillian McKeith PhD, you may be impressed by their credentials. McKeith was a member of the American Association of Nutritional Consultants, and her website once listed post-graduate membership of The Centre for Nutrition Education and certificates from the London School of Acupuncture and the Kailash Centre of Oriental Medicine. Not to mention that she was said to be “currently studying with The Australasian College of Health Sciences, USA to become registered as a medical herbalist.” McKeith’s view? “My qualifications are second to none. People out there would love to have my qualifications and expertise […] I could have gone anywhere I wanted but I chose Clayton. There was cutting-edge research being put forward by people who were pioneers at the time.” Meanwhile, Holford lists the following qualifications and positions held: B.Sc. Experimental Psychology, University of York; Dip.ION Honorary Diploma in Nutritional Therapy; F.BANT Fellow of the Association of Nutritional Therapists; Visiting Professor, School of Social Sciences and Law, University of Teesside; Director of the Institute for Optimum Nutrition; Consultant to the Institute for Optimum Nutrition; Patron of South African Association for Nutritional Therapy. I didn’t list all of Patrick’s “positions held”, but you can see the rest on his website – or you can view an annotated CV at the Holford Myths website. How does Patrick describe himself? “One of the most inspiring and informative health and nutritional experts at the cutting edge of health transformation.” Defence: we underestimate the impact of authority. “A fundamental form of defense against the problem, therefore, is a heightened awareness of authority power.” The trick is to recognise “when authority directives are best followed and when they are not”.

Scarcity

Patrick Holford’s full blog posts are only available to members of his club 100% Health*. The information he provides is “censored” in that the casual reader cannot access the whole post unless he (or she) has paid to become a member of Holford’s club. As Cialdini writes “The intriguing finding about the effects of censored information is not that audience members want to have the information more than before; that seems natural. Rather, it is that they come to believe in the information more, even though they haven’t received it.” To read Patrick Holford’s full blog posts, one must pay*. To read one of his books one must pay (unless your library has a copy of the book you wish to read). Could this partly explain why people are so willing to trust the advice that they are given by Holford? Defence: Cialdini claims that the possibility of purchasing something that is scarce leads to a state of heightened arousal. If we notice that we are excited about a purchase we can use that as a clue that we may be about to fall victim to scarcity tactics. We should also ask ourselves “why we want the item under consideration” – if we want it for its function, we should remember that it will work the same whether scarce or not.

More

Note: I make no assumptions as to whether those using weapons of influence do so knowingly, as a deliberate tactic.

It strikes me that Cialdini’s advice may be more applicable to dealings with car salesmen and those selling door-to-door than to dealings with nutritionistas and/or homeopaths. Nevertheless, there does appear to be some value in bearing Cialdini’s advice in mind when dealing with those selling information or products in the health market.

Wikipedia’s page on the Cialdini book: Influence_Science_and_Practice. Influence on amazon.co.uk.

Further Reading

Holford Watch have previously written about Cialdini and consistency and why this might influence trust in CAM. The Mind Hacks blog has a post about the book and they also link to a summary on happening-here.blogspot.com.

Edits

*It is not clear whether this is actually the case. His blog posts actually state on the members login section “the remainder of this article is restricted to users of the 100% Health Club”, but (not being a member of the 100% Health posse) I cannot verify this. It may, therefore, be the case that one does not currently have to pay to view Patrick Holford’s blog posts, just to comment on them.

3 Comments

  1. Ian Horsewell said,

    Your comments on scarcity and cost sounded familiar to me and after some trawling for a half-forgotten study online I came up with this:

    http://www.hbs.edu/research/pdf/05-017.pdf

    Gino’s research (may have been developed further since) suggests that simply paying for the information makes us value it more highly. This would seem to me to be a variant of the well-known placebo effect, where a more elaborate or costly intervention is more effective in ‘treating’ some conditions. Recent research suggests this is why acupuncture appears effective – it is an elaborate placebo. (similarly, I’m pretty sure Ben references work showing that placebo injections are more effective than placebo pills).

    Equally interesting was a link I found (not the study itself but I’m sure someone more adept can track it down) about research showing that a confident ‘expert’ caused analytical parts of the listener’s brain to be suppressed. I presume this was tested using fMRI, the usefulness of which I leave to those qualified.

    http://www.predictablyirrational.com/?p=647&date=1

    Note – some very interesting interpretations and conclusions are mentioned in some articles about the research, and I’m not sure how much come from the researcher, Gregory Berns, who is also an author and speaker…

    Hope these are useful/interesting.

    Ian

  2. jdc325 said,

    Thanks for your comment Ian – and thank you for the links, they look fascinating. The Gregory Berns paper seems to be this one: link.

    While undergoing fMRI scanning, participants made a series of financial choices between a certain payment and a lottery […] Behavioral results showed a significant effect of expert advice. Specifically, probability weighting functions changed in the direction of the expert’s advice. This was paralleled by neural activation patterns […] These results support the hypothesis that one effect of expert advice is to “offload” the calculation of value of decision options from the individual’s brain.

    The Gino paper states at one point that:

    The price attribute that people attach to the advice might signal quality (or advisor expertise), which, in turn, affects how people automatically receive and encode the information into working memory.The two studies were designed to eliminate the viability of this explanation, but may have not ruled it out completely.

    The bit I’ve italicised reminds me of an example of “betting the shortcut odds” given by Cialdini in Influence – he relates the tale of a woman who owned a jewellery store. She was trying (and failing) to shift some turquoise pieces and left a note asking her assistant to mark them up at x1/2 price. The assistant misread the scrawled note and marked them up at x2 price. Within a few days, all the items had sold – because people assumed that the high price reflected that they were good quality (i.e., “you get what you pay for”).

  3. Demetrius Bruce said,

    The hospital isn’t the only place you can go to get treatment. As a matter of fact, all over the world, people go to all kinds of strange and different places, and they find cure for their respective illnesses.

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