Via Ars Technica comes a link to a paper which seeks to explain with game theory why people continue to use unscientifically proven and usually useless medical treatments such as folk remedies or “alternative” medicine.
The researchers created a model to explain this behavior based on humans’ genetically programmed behavior to imitate. This surprisingly simple model shows that quack cures spread simply because their ineffectiveness means that people must use them more often and for longer times. This in turn means that more people see the use of quack cures than they see the use of effective cures, which creates more opportunities for imitation. In short, every person who uses a particular cure becomes an advertiser for that cure. The longer the cure takes and the more elaborate the cure, the more people accidentally advertise it.
For example, consider two people treating a bacterial infections. Individual A uses antibiotics while Individual B uses some New Age method. Individual A takes a few pills and becomes symptomless in a few days. In Fifteen days or so, he even stops taking the pills. The actual act of taking the pills takes a trivial amount of time and effort. Once the infection is cured, Individual A will not spend a lot of time talking about taking the antibiotics. There is little time or opportunity for anyone else to see the antibiotics-taking behavior and imitate it.
By contrast, Individual B uses an ineffective treatment and the infection persists, possibly for years. Individual B has a lot of time to talk to other people about the treatment. The treatment itself may be fairly elaborate and time consuming requiring special diet, special drinks, totems and numerous visits to practitioners. All of this creates more opportunities for imitation.
The more effective a cure, the less people are aware of it. Take the fate of vaccinations, the most effective medicines ever. Vaccinations have saved more lives than have all other forms of medical intervention combined, and they have done so at a trivial cost. Yet today, no one talks about vaccinations save in debates with people who criticize them. Almost everyone today knows about the debate over whether vaccinations cause autism, but very few people even know which diseases they are vaccinated against, or could tell you any of the symptoms of those diseases or the consequences of contracting them. Vaccination takes a trivial amount of time and effort, so there are few opportunities for imitation. By contrast, refusing vaccinations or suing vaccine makers creates a lot of noise and opportunities for imitation.
This mechanism could be applied to any behavior which could be imitated, such a political ideologies. If so, ineffective political ideas might have a competitive edge over effective ones. Like vaccines, effective political policies solve problems, which makes the policies themselves seem unnecessary. People don’t spend a lot of time talking about policies that quickly and efficiently eliminate problems. By contrast, ineffective policies don’t solve problems, which means that people talk about the policies more. This creates more opportunities for imitation. There are many thousands of times more books written on socialism of all forms than there are books written on the free market, because the failure of socialism makes it more visible and thus easier to imitate. If socialism worked neatly and efficiently, no one could make a living writing about it. One book would suffice, just like one book suffices to teach the basic of engineering.
I think a similar effect underlines the political culture of places like Detroit and other places in the Rust Belt. The very failure of the socialist policies means that people talk about socialist policies more, just as people talk about quack treatments more than effective ones. People’s natural imitative nature leads them to adopt the more visible and advertised political ideas. As the community grows sicker people cling even tighter to the most talked about policies just as people in the developing world cling to folk cures instead of risking the leap to scientific medicine. Even as they stand beside the graves of their loved ones, they can’t shake the instinct to imitate the most visible behavior.
This mechanism alone does not explain the persistence of ineffective medical treatments or ineffective political ideas. Many other factors obviously contribute, such as the economic interest of those who peddle ineffective treatments and ideologies. However, I think the researchers have pointed out a very powerful and previously unsuspected mechanism by which ineffective ideas spread due to that very ineffectiveness.
The world just got a little more explicable and little more weird.
There are far more stupid ideas around than sound ones. If people use something sound,and it works,they may eventually get bored and forget about it,and then be sold something stupid. When that failed they most likely will try something else stupid,there being such an abundance of foolish ideas. Bad ideas often have a short shelflife, but there is always more where that came from.
Renminbi,
It’s certainly true that there are more ways to go wrong than ways to go right but it alone doesn’t explain why the same ineffective ideas persist over long periods of time. Nor does it explain why certain bad ideas spread at one time whereas other bad ideas do not.
A runaway imitation feedback loop caused the very uselessness of the ideas is a rather elegant, if counter intuitive explanation.
Very elegant. “A runaway imitation feedback loop” is what a behavioral scientist would call a spurious contingency. This analysis also explains many superstitious behaviors.
While I find the imitation/feedback idea intriguing, there is another aspect that applies to both the medical and economic areas you refer to.
Modern medicine is somewhat cold and clinical. Although I have seen some improvement over the years, many doctors and nurses are painfully inept when dealing with people, and many treatments are administered with little or no understandable explanation as to why and how they work.
Non-scientific treatments, on the other hand, are often administered with lengthy discussions and explanations, however much they are all hokum. There are ceremonies, chanting, elaborate rituals, mysterious readings of energy patterns or some such, meditation, and all sorts of feelings inspired by being “in the know” about something that is non-traditional, trendy, and mysterious in a gnostic sort of way.
Homeopathy is a perfect example. There are consultations, elaborate teas and infusions and elixers, lengthy return visits, and refinements to improve the mixture or alleviate new symptoms.
Much of the appeal of alternative medicines is found in the elaborate ceremonial nature of many of their procedures, which draws the patient in as a co-practitioner with the shaman. A briskly efficient medical doctor prescribing a shot or some pills just doesn’t have the same cachet.
This also explains why the patient will swear by the alternative treatment and practitioner long after it is obvious the stuff isn’t working, while turning on the clinician even though the treatment prescribed was generally successful, but not perfect.
And, to extend the analogy, much the same situation develops in the transition from a traditional economy to a more capitalist one. Stores become larger and more impersonal. Products change continuously, manufacturers are increasingly remote, indeed, often in another country or hemisphere.
Products and services appear, pre-priced and pre-packaged, take it or leave it. Few people can understand how they were developed, produced, transported, priced, and what each sale means to the retailer, wholesaler, and producer in terms of profit, cost, and future investment.
Indeed, I remember reading about a survey taken a few years ago which showed the average profit margin people thought businesses made was from 20-50%, while the reality is less than 5%.
What is the common criticism of capitalism? That it is cold, cutthroat, indifferent, uncaring and unfeeling. The complaints about a modern business and a modern hospital are almost identical, and the more business-like it is, the more the hospital is criticised.
Socialism, fascism, all forms of collectivist mythology involve elaborate rituals of involvement and declarations of inclusion, as well as ritual exclusion of the “wreckers” and “kulaks”, and all other enemies of the workers or volk or community. There are constant references to feelings such as compassion, love, loyalty, sense of community, and how important they are.
It is an emotional need that goes back to the most primitive humans—the desire to have one’s feelings be recognized as important, and able to influence events.
Why do these utterly failed ideas come back over and over again? Because they promise that the feelings and beliefs of their adherents will be more powerful than some arcane economic rule, or the cold calculus of cause and effect.
Collectivism promises that water can become wine if everyone desires that it be so. Look how long, and in how many forms, that idea has lasted.
Veryretired,
I agree that a lot of the appeal of “alternative” medicine lays in the illusion of understanding and control that it gives to those who use it. Heck, I was educated as a biologist and it takes me hours of study just to get a rough understanding of how many treatments work in theory. I have at best a cliffnotes level understanding of what doctors are doing when they poke and prod on me but for most people it might as well be magic.
I like this paper because it reveals a previously unexpected mechanism. Everyone knows (or perhaps assumes) that people imitate what works for other people. However, it never seemed to occur to anybody that people would imitate practices that didn’t work just because they saw others using the practices over long periods of time. The very act being seen using a specific solution to a problem is enough to cause imitation. People make decisions based on what they see other people doing not based on the long term outcome of those actions. In other words, they imitate actions not consequences.
In writing this, I think this phenomena might underlie financial bubbles. They’re not investing in bubbles because they see other people getting returns, they’re just investing because they see other people investing. They’re imitating the act of investing and not the consequences of returns.
This makes sense when you look at the foundation of imitation, the mirror neurons. Mirror neurons simply reflect the actions of others. It is the fundamental mechanism by which human’s learn everything. Such copying does not require that the individual copying the action of another understand why the copied person acts as they do. Children mimic parents in all things even though they have absolutely no idea why parents act as they do or the consequences of carrying out the act.
As a adults, we like to thing that we understand why i.e. the consequences of our actions, but I think a lot of times we just fool ourselves. We decide to do something based on imitation and then create a justification later.
Yes, Shannon, but imitation becomes more than that when we are talking about parents, teachers, and those others in a society towards whom people look for insight in how to live. At a very fundamental level, we’re talking about learning how things should be done, not mere imitation.
As an example—I imitated my mother and grandfather when I was a teenager and started smoking. In those days, it seemed like everyone did, especially in the movies. It took many years before I understood the mistake I had made and quit. This was a learned behavior, but in a very real way it was the type of imitation you are referring to, I think.
Also as a youngster, I was my grandmother’s kitchen helper after school. She was a professional quality baker, and an old fashioned, make-it-from-scratch cook. I was much older before I realized that most other people didn’t eat the kind of well crafted meals, with sauces and gravies and side dishes, that I just took for granted.
From her I learned not only to cook, but to value cooking, and to view a well made family meal as a very special thing, an act of love and family intimacy. I, in my turn, have taught my own children of both sexes to cook wholesome meals, and, I hope, an appreciation for the reasons that mealtimes should be a special family time.
The point I am trying to make, rather awkwardly I’m afraid, is that we imitate, but also we learn, at a deeper level, from those around us, especially if the person holds a position of trust and authority.
Many of the difficulties we are having, and have had, come from learning lessons that are based on erroneous ideas, misplaced values, and outright fairy tales.
The deeper reason that snake-oil ideas keep being ressurected, like zombies in some old horror movie, is that otherwise well-intentioned people we value as teachers and mentors have deeply held beliefs, which they pass on as important lessons that we should learn and abide by, even though those beliefs have not brought the desired results in the past.
People cling to them, however, because to reject them would require a re-thinking of complex and fundamental ideas and positions—a re-examination of one’s entire approach to life. For most people, this is simply impossible. It is easier to look for scapegoats, or some type of magical reason why things didn’t work out.
I’m afraid that is the process we are currently engaged in during this “economic” crisis, which is actually a massive political meltdown with economic symptoms. And that’s why I am not optomistic about the potential outcomes, at least in the short term.
I think you also have to consider the effect of wishful thinking and the effect that years of history have on medicine. Dawkins, in his video, “Enemies of Reason” does a great piece on Homeopathy and concludes what Shannon points out about placebo effect and good human care.
Religion suffers (or thrives depending on your perspective) because of the same phenomenon I believe. It’s a testament to how much our species is slave to its own survival programming. One day we will evolve.
https://www.amazon.com/dp/0805070893?tag=httppartypebl-20&camp=0&creative=0&linkCode=as4&creativeASIN=0805070893&adid=1V06VNQHNGWERG7BMFZM&
Excellent book on the subjet.
It is funny that people want to distrust sciene.
Science write Simon Singh has a new book out that reviews the double blind studies for many alternative therapies. His conclusions: Homeopathy and Acupuncture are placebos, Chiropractic Therapy’s claims that it can cure disease such as asthma are placebo except for possible spinal muscle/skeltal benefits (and physical therapy appears superior for muscle/skeletal issues with less risk of injury and less cost), and Herbal Medicines can be effective but carry risks due to large number of the chemicals in the plants as compared to medicines that use the Herb’s refined active ingredient.
http://www.amazon.com/Trick-Treatment-Undeniable-Alternative-Medicine/dp/0393066614/ref=sr_1_1?ie=UTF8&s=books&qid=1240334584&sr=1-1