Over on Things That Remind Me of Robots I posted something about coming back to watch the X-Files, 10 year later. I won’t rehash it here, but it has got me to thinking a lot about the notion of Big Truths.
Let me offer a definition: A Big Truth is something that you have to sacrifice previously held beliefs in order to believe in for the first time. You have to stop believing one or more things that you have taken for granted: as articles of faith, obvious facts, commonly accepted truths. Then, you have to start believing something else, something that contradicts, or at the very least replaces, those previously held beliefs. Regardless, you can’t believe the Old Truth and the New Truth at the same time.
I’ve generally encountered this sort of problem – how to tell the Big Truth so people will believe it – only in pharmaceuticals. Specifically, I encountered it working with the cervical cancer vaccine. How could we convince young women and the mothers of girls to get a vaccination against a sexually transmitted virus that causes cancer and genital warts? There was a lot to unpack in that brand and product proposition.
We did a lot of focus groups talking to young women and moms about cervical cancer, vaccinations, HPV (human papillomavirus, the type of virus that causes cervical cancer), and sexual and reproductive health. We’d talk about the vaccine, show them descriptions of the ways the vaccine is administered, the strains of virus it inoculates women against, the causal relationship between the virus and different diseases, efficacy results, safety indications, and so on. For two hours, everyone would nod their heads and say things like, “the virus that causes cancer” and yet, I often felt that somehow we were not getting through. So I drew this diagram on an easel:
When we showed people this diagram, suddenly the participants would stop in their tracks. Despite the fact that this idea was at the heart of a two-hour discussion, and that this is what people told us they understood, it was not until we drew this diagram that they really understood what the idea really meant.
More than that, they were shocked. Not only had they not really not understood what we were talking about, they found what we were talking about very difficult to believe. All the way through the conversation they were intrigued by a vaccine for cancer, concerned about the implications, questioning efficacy, and musing about the importance of safeguarding their own or their daughters’ health. But suddenly their seeming engagement with the topic was subsumed by confusion, dissonance.
And this is where it became clear: they understood the concept; they just didn’t believe it.
Why not? Because it required them to overcome a series of competing beliefs that they already had – ideas about what causes cancer, fears about vaccines, social norms about sex and sexuality, moral judgments about prevention and treatment. We were asking them to believe that (A) cervical cancer and genital warts are caused by the same family of viruses, (B) these viruses are passed through sexual, skin-to-skin contact, (C) the vaccine inoculates young women against the strains of the virus that cause 90% of cervical cancer and 70% of genital warts, (D) the vaccine is safe, so that (E) it is a good idea to use the vaccine on young women.
What they already believed was some cocktail of the following:
- Cancer is hereditary – if no women in your family have had it, you won’t get it.
- Cancer is caused by environmental or lifestyle factors – if you live a healthy life, you probably won’t get it.
- Sexually transmitted diseases are transmitted by fluids – to get a sexually transmitted disease, you have to have vaginal, anal or oral sex.
- Young girls – in particular, pre-pubescent girls – do not engage in sexual contact.
- Condoms prevent all sexually transmitted diseases.
- Abstinence definitely prevents all sexually transmitted diseases.
- Vaccines are not safe – they cause autism, longer term illnesses, the illnesses they seek to prevent, flulike symptoms, or simply don’t work.
- You shouldn’t sexualize young girls by subjecting them to treatment or prevention of sexually transmitted diseases, much less discussing these treatments with them.
- Only promiscuous girls get sexually transmitted diseases.
- People who get sexually transmitted diseases deserve it.
- Sexually transmitted diseases, like genital warts, are treatable.
- Cervical cancer is treatable if you get regular cervical screenings.
- The risks of the vaccine outweigh the likelihood that a woman will get cervical cancer.
Most of what people already believed was either inaccurate, incomplete, or flat-out untrue. People’s ideas and attitudes towards sex and sexuality colored the rest of their beliefs about both the disease and its prevention. We were asking them to abandon all of these previously held beliefs, forget the misinformation, delete their incorrect inferences, and believe something new. We had science on our side, we had common sense on our side, but the one thing that worked the most effectively surprised us: fear.
The people most prone to abandon their previously held beliefs were people with intimate experience with, or a deep-seated fear of, cancer. If you are terrified of cancer – and if you’ve ever known someone who has been treated for cancer, you understand this terror – then you are willing to abandon these beliefs because the new, Big Truth, transforms your understanding of cancer: from a terrifying, mysterious, deadly or disfiguring disease into something preventable, something you can spare yourself or your loved ones. In other words, our Big Truth inspired a hope and sense of possibility, even relief, that abated their fear. It was as if, for those who were scared, we’d turned on the light and shown them that the monster under the bed was just an errant stuffed animal.
But if you weren’t afraid of cancer – if you considered it a remote possibility – then the Big Truth was at least confusing, and worse, confounding, contradicting too many things you already believed.
It’s not often that we encounter brands and categories that trade in the Big Truth, or feel they have to, or have an opportunity to do so. And who would blame them, when they can simply tap into what people already believe in and leverage these beliefs, even if they are based on falsehoods, to sell products or brands?
But I recently encountered this idea again in the context of electric vehicles. People ‘get’ EVs. But they do not have personal experience with them, generally, so their understanding is necessarily abstract. As a result, the people I spoke to were shocked again – to discover that there would be upwards of a dozen different makes and models of EVs by 2013, that tens of thousands of EV charging stations will be installed throughout the country by the end of this summer, that plug-in hybrids and plug-in electric vehicles are coming, and so is the infrastructure for them. In their minds, the abstract notion of widespread adoption of electric vehicles was 5 or more years away. Embedded in their abstractions were prejudices about EVs: that they are small, lack power, don’t drive at highway speeds, aren’t safe, aren’t reliable, can’t go far enough, are expensive to maintain, aren’t fully proven as a technology. Some have gone to another extreme – that all sources of electricity are suspect, produce emissions, cost resources, and so on. These previously held beliefs hindered the depth of our discussions – too many hypotheticals were required to have a robust conversation.
Yet – an interesting belief was also embedded in our conversation about cars and energy. Most of the people I spoke to believe that what kinds of cars get made, what kinds of energy sources we use, what energy costs, and what brands are available in this market are elements that are simply not up to them. The fact of this technology is fascinating, inspiring, concerning, but not within their power to control. What brand of charging station will I plug my EV into? Whichever one is installed on the street, in the parking structure, at my workplace, sold with my car. What kind of EV will I drive? Whichever kind I can afford, or like the looks of, or that my wife likes. People were confused, surprised, but not stressed out in the slightest. Electric cars are coming, resistance is futile, let it wash over you, and do what you will.
The cancer vaccine, on the other hand, was entirely up to them. It wasn’t mandatory yet, it was the responsibility of a parent, or of an adult. So when you combine believing in a Big Truth with placing the enactment of that belief solely within the responsibility of an individual – when believing in a Big Truth requires you to be responsible for the results of that belief, then people resist. They resist hard.
I’m not sure what the answer is, and suspect that advertising or marketing are ill-equipped to take people very far in the process of overcoming previously held beliefs and adopting a new Big Truth. But it is an interesting problem and one I suspect we will continue to face as scientific discoveries become products in a world where brands and communications are everything.