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Wednesday, January 18, 2012

The Art of Medical Deception (Advertising, Part I)

 One of the things that's so interesting about Kahneman's book "Thinking, Fast and Slow" is the notion of "self deception."

Basically as I understand what he says there is "What You See Is All There Is" or WYSIATI.  WYSIATI is what your "System 1" uses to assess your current position in the world and it does this by only using what it can see, i.e., if I can't see it I'm not worrying about it now.

Since you really cannot see that much of what's around you at any given point in time your "System 1" (the part of your mind that grabs sensory input from the outside and draws conclusions, e..g, "there's my friend Bob") manufactures the rest of the reality it needs to complete its world view (like what's behind Bob, what's Bob wearing, and so on).

Much of the first part of the book (I am now about 1/2 way through) is relegated to how this happens, experiments conducted by Kahneman that demonstrate how "System 1" leaps to conclusions with very little data and how hard it is to detect this, i.e., you don't consciously realize that you are drawing these conclusions yet you act on them.

I interpret this all to mean that your mind (at least "System 1") is a vast, holographic pattern matcher.  Visual, auditory and other sensory input is continuously received and shoveled into the pattern matcher.  The pattern matcher takes all of this and jumps to a simple conclusions about your current "world state"  The patterns match at all levels - this is my house, my dog, the route to work, I'm hot, its raining, and so on and so forth and yield a kind of "how I am now" state in your mind.

Things that are not easily matched get "ignored" by "System 1" basically sweeping them under the rug, as it were.  This is why people do double takes, why you can hide things in "plain sight" (your mind simply ignores them as if they were not there - which is why you "overlook" your keys lying right in front of you), why you can drive on "autopilot" (I don't remember driving to work yet here I am), and so on.

The patterns get matched into states of consciousness I guess, e.g., I am home, I am at work.

Your mental "model" of the world is updated - but not directly by all the sensory input - only when your actually realize something is new or different.  "System 1" I think says "you are at work" - and the rest of your brain handles the model of "work."  (This is why when someone moves a chair in a familiar room you have to bump into it a few times - your mind does not work off of what you see but instead a mental model of the room and the "moved chair" doesn't fit in at first.  The chair is just "assumed" by "System 1" to be where it always was so it not looking for it somewhere else.)

Now what about the state of your body?

At least so far Kanheman does not relate these ideas to how "System 1" models your internal body status.

But I think it must, and in the same general way.

As I wrote in the last post new studies show that your "brain and digestive system" are connected (Duh!) in ways that modern medicine has not thought about (this article).

But it makes sense if you think about.

You don't normally have conscious recollection of, for example, the details of what your small intestines are doing while digesting your dinner - somehow your brain translates those experiences to high-level ones: I'm full, I'm sick, I have gas, and so on.

Yet clearly your brain is controlling them (either directly or indirectly).

One thing I think "System 1" does relative to your digestive system is focuses on things you need to eat, i.e., cravings.  Anyone familiar with a pregnant woman knows this: "I need licorice and pickles right now, honey...".  Presumably "System 1" received input to this effect.

Your mind must understand what your bodies nutritional requirements are at some level and directs your conscious mind to act on those needs.  Similarly for things like thirst, going to the bathroom, and so on.  At least for me when I am really thirsty I imagine or "see" images of a large glass of cold water, etc.  You probably do too.

Even the dog knows when he needs to go out, eat, etc.  He nudges your arm, pulls your foot, barks, scratches at the door.  Clear even his animal brain is able to convert bodily needs into "higher level" functions like "scratch at the door."

"System 1" also understand about things like timing: "Should I pull over at this rest stop or the next one...?"  It can provide you a model of what will happen to you if you don't pull over now: squirming, stopping at the side of the road, etc.  Again your bodily needs are translated into simple high-level thoughts by your brain and body automatically and without thoughtful intervention on your part.

More intriguing is the relationship between your gut bacteria, your health and what your brain thinks is going on.

But what's the point of all of this.

I guess a couple of things.

First off, it seems pretty clear that from the perspective of what you body is doing medical science has a long, long way to go.  Last post I mentioned it was like trying to understand an oil refinery with a microscope.  I think that's a pretty accurate analogy.

While the microscope reveals what is going on - its only at a small scale relative to the entire refinery and its without knowledge of how what is being observed fits into the larger picture.  (Of course the more microscopes and coordinated effort the more pieces you can obtain and, hopefully, correctly fit together.)

But this is like the keyhole problem - you don't know how much you don't see.

Sure you can find a wire, tap in and send in a signal to toggle a relay - but what does that do the overall refining process?  Does it work better?  Maybe it turns off something so the refinery works with less energy, that is, until it explodes.

I guess this is the reverse of WYSIATI: You Don't Know What You Don't See (YDKWUDS).

Our minds have to simplify what they perceive in order for us to make immediate sense of the world (another of Kahneman's points).  In doing this he has shown that our minds are perfectly happy to take short cuts (often incorrect ones) without out conscious knowledge (again documented by Kahneman).

So I am thinking that our minds generally are unable to process the wealth of information that flows to them every day through all the various media sources because they are not designed to function in that way.

Our minds are not designed to handle today's information flow.

On the medical side we might see ads for various medications, read articles about various health problems, but at the end of the day our "System 1" has to pattern match all of that into something it (and the conscious you) can easily grasp and identify with.

So we get things like "cholesterol is bad," "nicotine causes cancer" and "I want to be able to have sex when I am old."  All "System 1" gross generalizations of what otherwise occupies many, many researchers and millions or billions of dollars.

Secondly I see that unscrupulous marketers take advantage of that by packaging things in such a way as to amplify the generalizations - often by using a sort of "reverse placebo" effect.

You see an ad for a woman holding her stomach and looking uncomfortable.  "System 1" hones in on it.  "Buy my yogurt!" says Jamie Lee Curtis.

Is the yogurt going to solve my problem?  "System 1" doesn't care because the image you saw relates through the pattern matching I described to how you feel about yourself (or someone else).  Maybe I have gas for other reasons, but because of YDKWUDS you can't process what else might be the cause - at least not quickly. Maybe I just feel as if the product might help me because I might (reverse placebo) have the same problem.  In fact, maybe I'll start to worry about it, my stomach will hurt, and I will buy the yogurt as well.

So, for example, the marketing company is literally targeting your brain/digestive system interface with these yogurt ads because of the visceral reaction you might have through "System 1".

Kahneman has shown that this reaction really cannot be controlled.  Your reaction is almost fully automatic.

So if you have a gurgling stomach I believe that your mind is going to leap to the conclusion that this yogurt product is something I must buy (unless you've had a lot of conditioning to the contrary).  Your "System 1" brain is linking its feelings about your internal body state (gurgling stomach) with the image on TV of a happy customer eating yogurt.

This linkage happens in milliseconds, is beyond your control and so fast that you cannot react quickly to the result (your "System 2" - the "thinking" part of your mind is lazy, according to Kahneman), and so if "System 1" thinks the yogurt is a good idea it goes on the shopping list almost outside of your control.

The same for sizzling pizza when you're hungry.

The same for Cialis if little "mr. happy" is feeling blue or troubled.

And so on.

Personally I think that medications and food are two different things as far as advertising goes.

You can decide if your hungry or not fairly easily on your own.

But what about that nagging cholesterol thing...?

Then there is the social aspect: what if I am the only person at the party not on Lipitor?

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