The September issue (September 2011, v.6, no.5) of Perspectives on Psychological Science contains a series of essays on new models of delivery for fundamental mental health services. While we’ve got a pretty good science for clinical psychology, getting it out to the Other Guys is expensive and difficult. The essays all address large scale public delivery of effective clinical treatments. That means anything other than the proven method of face-to-face interaction with a therapist in controlled settings with either individual or group meetings. One proposed large scale delivery intervention on priming raises a couple of interesting persuasion points.
Shalev and Bargh suggest that priming could be a cheap, easy, and effective clinical modality that could apply in a wide variety of specific cases. They outline a series of priming examples that have been proven in the lab to produce positive emotional and cognitive changes in people that are at least as effective as many individualized clinical treatments. In terms of faster, cheaper, better, Shalev and Bargh make the case for public mental health priming.
While Shalev and Bargh don’t cite this, the subliminal work from Lloyd Silverman provides compelling evidence of the clinical effectiveness for priming. You can read more about it in the Primer chapter on Subliminals, but very briefly, Silverman conducted well controlled studies with seriously ill people using “Mommy and I are one” as a key subliminal message. It worked. As a 1990 meta analysis from Hardaway in Psychological Bulletin reported, the average effect for this treatment is a Smallish Windowpane, about a 40/60 effect. So even past Shalev and Bargh, there’s some good evidence that priming does work.
Consider two persuasion problems.
First, think about Box and Play. The Priming Play is proven to work in the Box called Experimental Lab Settings. I don’t know of any large scale field testing of priming in natural settings. We’ve looked at this with the Queen of Tomorrow and subliminal applications in marketing, sales, and, cue the creepy music, Big Brother politics. While we are getting closer to priming in public, the technical demands of delivering effective subliminals or primes defeat practical application. You’ve got to control the visual or auditory field of the Other Guy who is moving through life. That’s extremely hard to do. So, the jump from the Box called the Lab to the Box called Life is a major persuasion problem.
And, even the previously noted Silverman work with “Mommy and I are one” interventions took place under controlled conditions and not as part of a field study. And often times, the participants in the intervention were specifically misled about the subliminal training and given a cover story to explain the computer apparatus and the procedures with it. People knew they were in a “study,” but they were clueless about the specific priming intervention aimed at their mental health in most cases.
To summarize the first persuasion point, the good evidence in support of priming for mental health is restricted to a particular and unique Box and Play. We don’t know whether it generalizes to other Boxes without that obvious experimenter/therapist presence and control.
The second problem is awareness. Even past the impact that informed consent would have on this application, all the research I’ve seen on priming and subliminals indicates that if you have conscious awareness that the Prime is out there then the impact of that Prime is strongly reduced. Thus, in the standard kind of public mental health intervention, you’d have to tell people about priming and subliminals (informed consent), but then you’d have to make sure you deliver the intervention without their awareness that you are doing it.
Think of this through the movie, The Truman Show. A baby named Truman is raised in an environment that looks like normal life to Truman, but is actually a Hollywood sound stage. Truman’s life is just a reality TV show. As long as Truman doesn’t realize he’s in this controlled environment, he thinks he’s the Captain of His Ship, the Master of His Fate when he living in a When-Do-Get machine controlled by the TV director.
The Priming Box and Play proposed here for public mental health in essence puts Other Guys in The Truman Show. They sign off with informed consent for the un- or sub-conscious primes that will deliver better mental health. So, they know they are in the movie. Will the priming still work under these conditions of awareness? Just think of the attributional impact of this and how it could mess with your head.
You’re feeling lousy and your psychologist suggests that priming could help you. You sign up, informed consent and all, then wait. Some days you feel better than usual. How do you attribute it? Is it the priming or something else? How will you know not only that you feel better, but that you feel better because of those unconscious primes because you cannot ever know when the prime is On? Yet, if anyone would propose doing this to you without your knowledge, we’d have serious legal and ethical issues.
To summarize the second persuasion problem, awareness of priming tends to reduce the effectiveness of the priming. In experiments we can design cover stories that deflect awareness, then do a debriefing. In a large scale field application – priming on the Web – people would have to initiate the intervention on their own accord, which means they would have some kind of awareness with all those attendant effectiveness and attributional problems.
If ever there was a case for More Research, this is it. Can you deliver clinical priming through a website and still get the effects from the Lab Box? And, how do you handle the informed consent, awareness, and attributional problems inherent in this situation?
Finally and just to raise the creepy specter of Big Brother again, imagine that therapeutic priming on the web can be done efficiently and effectively. Assume that More Research answers my two persuasion problems and we’ve got Dr. Feelgood online all the time. That means we’ve found a socially acceptable way to change the way Other Guys think, feel, and act in practical, clinically significant, not just statistically significant, ways . . . without the Other Guys knowing this happened or how.
The history of the 20th century documents that many smart and well meaning people thought that government should be used to shape the New Man, the New Soviet, the New Fascist, the New Nazi all in the service of a better world, the perfection of humanity as the inevitable product of evolution’s assumed march to excellence, the Fittest of the Fit. If we’ve got Feelgood Online why not bring it into government to solve intractable social problems like ignorance, poverty, disease, and crime? The rest is just the persuasion gravity of falling off the log.
Persuasion affords such imaginings. Perhaps we can. Persuasion theory and research points the way.
Perhaps we should? Persuasion says nothing about that.