The science of genetics has produced hope and belief in personalized medicine. Consider the particular case with cancer.

A new world has been anticipated in which patients will undergo a needle biopsy of a tumor in the outpatient clinic, and a little while later, an active treatment will be devised for each patient on the basis of the distinctive genetic characteristics of the tumor. The path to that new world is already being cleared, with several companies now marketing genetic tests that measure the genetic signature of a tumor, with the expectation that this signature will direct the choice of treatment and predict treatment outcome.

New science testing that proposition produces bad news. Researchers ran state of the art genetics fingerprinting on single tumors and found . . .

In this issue of the Journal, Gerlinger and colleagues map out the remarkable heterogeneity within a single tumor . . . Thus, a single tumor biopsy, the standard of tumor diagnosis and the cornerstone of personalized-medicine decisions, cannot be considered representative of the landscape of genomic abnormalities in a tumor.

Stated another way, a tumor will mutate over the course of time and treatment making personalized medicine of this sort not the hoped for one-shot test, but rather a continuing chase by physicians after an ever changing cancer. This is not what some expected.

Yet, if you are a scientist even this bad news is good news. Science is more like a chase than people realize. You need to have the experience of looking at a pile of dead data analysis on a printout or computer screen to appreciate this. A lot of science is the pursuit of failure with a few successes along the way.

Consider how much resource our society has devoted to the particular area of cancer and genetics. Literally billions of dollars and while treatment is improving, only those with a book, a pill, or an herb would say that we have a cure for cancer. Most of that money has purchased bad news like this, yet this is how science operates.

Now, compare this kind of science to the kind of Scientific Science I criticize on the Persuasion Blog. Scientific Science seems to operate without failure, ambiguity, or uncertainty. Everything is proven beyond argument – with global warming as just the loudest current example. While cancer and climate change are very different phenomena both operate at a daunting level of complexity. So, cancer genetics eludes us, but climate change doesn’t? Sure. Global climate change is a lot simpler than cancer or genetics. Or is it?

While I’m pretty sure that this story is true in the details, I think that it is not true in the main point. The NYTimes profiles a sweet and loving academic who built a computer model of health insurance that drove Health Care legislation.

Mr. Gruber has spent decades modeling the intricacies of the health care ecosystem, which involves making predictions about how new laws will play out based on past experience and economic theory. It is his research that convinced the Obama administration that health care reform could not work without requiring everyone to buy insurance.

Jonathan Gruber’s equations proved beyond reason, doubt, and faith that reform would fail without the mandate that all individuals must participate. You see the trail in the enthymeme. The equations prove reform requires the mandate. The equations are irrefutable Science. Legislation then requires the mandate. We now wait to see whether the mandate is Constitutional, an element in reality apparently omitted from computer models.

Just as I assert that there are No Laws of Persuasion, I’d extend that to say there are No Laws of Computer Models. The Rule proves itself. If you could Lawfully create Computer Models of complex systems, you could control and manipulate those systems at your whim, impulse, or insight. Without much effort you can find fabulous failures of computer models for economic phenomena like the stock market, climate change, and just about any complexity in the world some bright thought he could fashion into wings and fly to the sun. Modeling is a fun tool for developing theory, but is a proven failure as even a metaphor for reality. Life does not operate like a model.

What, a math geek disdains math models? No. As a persuasion geek I disdain math models that exclude persuasion concepts. They’re great for Science, but terrible for Change. By definition the exercise had to assume that everything in the model was at least legal and would be properly written into law. If that assumption is wrong, the equations may still form a great model, but they have no meaning or worth in the real world. As a persuasion guy, I think that models alone usually do not capture all the relevant features in the Local, as in this case, considerations of Constitutionality.

The modeling failure here is not in Gruber’s work alone. The failure is in making the models too small and excluding how to write and pass the legislation so that it gets the science you want along with niceties like surviving court challenges. FauxItAlls often fail to see that turning science into practice requires science plus persuasion and not science alone. As a great and terrible illustration, theoretical physicists alone did not build the atomic bomb that ended World War II. Without engineering, the device was nothing more than a computer model of Bang! You’re Dead. Analogously, I metaphor that these computer models of health insurance are little more than expressions of Bang! You’re Cured.

Let’s begin with only a recent case. The NYT describes new science on the perils of climate change from flooding. They cite favorably a reliable source, Climate Central, for their new study on rising tides, floods, and destruction in America. So. Who is Climate Central? Here’s their current logo.

Hi, I’m with Climate Central. I do science, sound science. And media. Vibrant media. Trust me. I know climate change. I vibrate with it!

If you want to understand why climate change campaigning has done so poorly you need look no farther than this instance of NYT reporting on plucky Climate Changers. What kind of Other Guys will Change with media, vibrant or merely buzzing? Children. Earnest teens and young adults. Fellow media vibrators. But, any Other Guys who write legislation, run executive rule and regulation, invest capital, hire workers, in other words Other Guys who make the world go? No.

Consider how many smart and highly resourced people are working on this persuasion problem over so many years and in well connected and well organized groups. What have they got to show for it? Proclamations, agreements, treaties, statements, petitions that express the science, intention, the blueprint for climate change policy, but, alas only minimal policy or behavior change. Even when key elected officials express support for climate change policy, rarely does such policy arise and the success in legislative sources is worse. Modern climate change persuasion is more buzz than cut which again poses the question, why?

Begin with this recurrent partnership between journalism and Public Science organizations. News sources trumpet press releases from these Kindness From Strangers science groups in an eternal back scratching cycle that merely promotes one another’s name. They hold meetings, conferences, and parades then issue proclamations, policies, and demands which news sources cover endlessly and with no serious Change in the Other Guys who matter. If you are serious about climate change you need to realize that your current relationship with the NYT is killing your TACT. (Of course it may generate donations, but that’s not your purpose, is it?)

Now move to the Communication Cascade. Persuasion uses messages to move Other Guys through a series of steps from Getting the Message to this, that, and the other until you finally get to the point: Behavior Change. The Cascade says you move Other Guys from Reception to Processing to Response and then you get Behavior Change. Like this.

When you apply this simple sequence to climate change campaigning you realize that they are very good at the first stage. They generate a ton of Exposure everyday that translates into Reception. Everyone is getting the message. But after Reception, climate change campaigning fails at either or both Processing or Response. We know this because the key Other Guys are not Changing their behavior to the campaign desired TACTs, despite all the Reception.

The din and drone of the daily digital buzz machine does nothing more than Expose people to climate messages, much like a pathetic flasher standing on the same corner every day doing the same trick. Him, again. Everyone is surprised enough when a flasher flashes, but then they realize it’s just that guy again and the Cascade stops right there. All buzz, no cut.

If you want a case study in bad persuasion, just look at the shiny noise machine from climate change. In their own way they are as unskilled, inept, and unteachable as the Lifestyle Police. They each and all do the same bad thing day after day with the same knowable bad outcomes and all the while maintain a bright, earnest, and sincere self appreciation.

The only smart persuasion with people like this is to sell them something. Offer slick products and services like the Acme Company with Wile E. Coyote. Always some new gizmo, gadget, or whizbangery that will – guaranteed!!! – catch the Road Runner.

P.S. Maybe groups like this are funded by the very industries, business, operations, and practices that are being attacked. If I was running a large corporation that had any real or assumed impact on climate, I’d secretly fund a large climate change group and attract everyone in one place. I’d schedule meetings, conferences, and parades. Then I’d award prizes, ribbons, and photo ops. I’d make sure the New York Times was a major partner with a little NPR on the side. I would even fund counter-advocacy groups who would not need as much money or attention because they just like being contrary. Then the two noise machines would distract everyone to the sidelines so I could get my work done.

P.P.S. Of course this is not true, much less possible. It’s a Queen of Tomorrow scenario and would require somebody who knows the Laws of Persuasion, not the Rules. And there are no Laws.

Right?

One of the great things about growing up slightly Southern in the 1950s is all the great health stories I can relate. When I was a little kid I had bad earaches, but my mom had a fabulous down home solution. She’d sit me her lap, whispers sweet nothings in my ear while blowing smoke from her cigarette. Of course, I’ll probably develop cancer of the ear someday and her treatment was no cure for my earaches, but it sure felt good.

Which may be your response while reading . . .

And noise is no minor nuisance. It is one of the great underappreciated health hazards of our time—the secondhand smoke of our ears.

Thus, begins yet another attempt to persuade with the smoking metaphor. Beyond the fact that second hand smoke is largely a Tooth Fairy tale with trivial effects in highly adjusted equations – please, read the methods and results – the smoking metaphor is merely this writer’s attempt to model my mom and blow smoke in your ears.

No doubt, smoking is the single most destructive health behavior you can perform – again, please read the methods and results. That smoking kills is so obvious that everyone, including the tobacco companies, feels the Apples Falling on their heads. Thus persuasion muggles seek the Smoking Metaphor as the Low WATT drug of choice to lull readers into WATtapping agreement. Ahh, noise is like smoking (second hand), sip, tap.

And what about Noise? Again, read the damn methods and results section, not the damn headlines, intro, or discussion. Noise was an important area of study at NIOSH during my time and among specific occupational groups was a major concern, but note the worst effects were highly limited to very specific conditions and almost always under very long exposures, years and years of a career. As I’ve noted before, usually the largest problem to persuasion here was not workers or owners, but the damn zealots blowing their horns for the Noise Bandwagon.

With everyone living so long nowadays, you are virtually guaranteed to experience hearing loss pretty much regardless of your actual exposure to dangerous noise levels. Aging gets you everywhere. If you are a zealot who confuses passion for science, then this increase in hearing loss must be a capitalist plot to rob the 99% of everything including their ears.

With today’s quote we see this zealotry on a smaller scale, but with at least an attempt at persuasion. The author is making the best case to sell a book and if you buy noise as second hand smoke then he’s tripped you over the persuasion log and letting the persuasion gravity of that metaphor pull you in his direction.

There’s a Difference Between Persuasion, and Smoke and Mirrors; with Persuasion the Illusion Lingers.

Usually we look at persuasion aimed at those Other Guys, everyone else, but you. Sometimes, however, the Other Guy is you as when you want to change a bad habit, strengthen a good one, or acquire a new routine. Self persuasion is still persuasion. Let’s consider one maven’s thoughts.

Paul Carr has a new book that describes how he broke his alcohol addiction. He disputes the method of Alcoholics Anonymous for many reasons, but persuasively employs the 12 Steps as his book’s structuring device.

Step One: Ask Yourself, “Do I Really Have a Problem?”
Step Two: Quit Publicly
Step Three: Don’t Fear Failure
Step Four: Pull Yourself Together
Step Five: Stop Lying
Step Six: Stop Apologizing
Step Seven: Rediscover Dating
Step Eight: Replace Your Ridiculous Drunken Stories With Ridiculous Sober Ones
Step Nine: Spend Money on Stuff You Won’t Lose
Step Ten: Take a Difficult Test
Step Eleven: Work Nicer, Not Just Harder and Smarter
Step Twelve: Forget Everything You’ve Just Read

As pop press self help books go, this one may not be bad persuasion advice, except for that final Step that tells Grasshopper to find a path that differs from Master Po’s. I once had a prof like this and I’d still beat him up if I saw him in public. You don’t lead students down the wrong path to help them find the right one. Call it Zen Then, Tao Now, or Tenure For Life, it’s always bad teaching in every culture, zeitgeist, or screenplay.

Past my bias for happy endings, Carr describes several persuasion principles in his renunciation of AA, most notably the principle that makes AA effective: Social norms. Carr calls this Public Quitting which is the same thing as standing up in an AA meeting and declaring, “Hi, I’m Grasshopper and I’m an alcoholic.” When you confess an identity to a group that has an interest in that identity, you are creating Norms that will pressure everyone to think, feel, and act in particular ways to the exclusion of others. Carr wants you to do this with your friends, coworkers, and family. AA adds strangers and God.

Beyond this major similarity with AA, Carr does provide other effective self persuasion plays. Most of them aim at getting you away from the past behavior – stop apologising, get new stories – that would change how you think about yourself. I also like his Self Challenge play. You need to push the boundaries and make the new habit stronger than the old one. Assuming it works, and that is a risk, you’re doing a Self Inoculation play where that which does not addict you makes you stronger.

Yet, all of his plays share one commonality: You always have to pull the trigger. Carr’s self help guidance flounders where all self help pilots hit the rocks: Will power. Hey, Grasshopper do this and that, then that and this, and you will find the way.

Truly, you will. But only if you have the will power. Most of us simply cannot summon the required self control that is required to kill a bad habit and nurture a good one. Many of the scientific and not so scientific Persuasion How-To’s we look at on the Persuasion Blog fail precisely for this reason. Yeah, you will lose weight if you buy and eat only raw veggies, soy milk, and Max Thinner Protein®. But, you’ve gotta do this under your own steam everyday for months or years and that’s will power.

Heck you don’t need to walk any farther than the nearest mirror to prove this. Just one glance and you see your failures leap off the surface. And, you know exactly why you failed and what you need to do to succeed. Look around your desk top or drawer or some computer file directory helpfully labeled, Quitting. You’ll find your plan to lose 20 pounds, quit smoking, stop gambling, and on and on with the list of afflictions we all share. So, what happened?

I smoked a pack a day for 13 years and would still be smoking if I knew it wasn’t killing me. And after 30 years of abstinence, I still get cravings to light up a filterless Lucky Strike and smoke my brains out. It took me over 5 years of failure before I quit in 1982, going cold turkey with a thick rubber band on my wrist that I snapped every time I had the urge to smoke. Pain beats impulse and after that first day, my wrist was bleeding. But, the nicotine cleared my system and by the next day, I didn’t need to snap nearly as often and by the end of the week, I was nearly clear. I wore the rubber band for several months if only as a threat. So. Why not add a thick rubber band to Carr’s list?

I don’t think I could have done it hard enough every day for a week. If the nicotine impulse had continued as strong every day as the first one, I would have run out of limbs, skin, and blood, but more likely, self control. Willing oneself to pain has limits.

There’s a voluminous literature on self control and regulation. Some of it illuminates what is politely called the Illusion of Control. I’d suggest that most pop press self help books like this operate exactly through that Illusion.

Now, Grasshopper.

Addiction is the powerful outcome of persuasion that resists change. Nothing works well, with simple steps, and easy application. When you combine substance dependence with habit you’ve got something close to Superman and Wonder Woman in your head. If you want to change, the science points to science and not self help. Realize that reading a self help book is your evil addiction’s way of keeping you addicted with the Illusion of Control.