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Why It Matters That Jolie Wrote About Her Medical Choice

The views expressed are those of the author and are not necessarily those of Scientific American.


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Why does it matter if one person decides to tell the world that she’s gotten a double mastectomy?

Well, if that one person happens to be Angelina Jolie, it means that there will suddenly be a whole lot more people who now know about the harmful consequences of having a faulty BRCA1 gene, a genetic mutation that greatly increases a woman’s risk of developing breast and/or ovarian cancer. Thousands of women who have never heard of this gene will now know that if they happen to have this mutation as well, their risks of cancer could be greatly reduced through preventive mastectomies (removal of the breasts) and salpingo-oophorectomies (removal of the Fallopian tubes & ovaries). And it means that all of these women (and men) will now have a very public, very identifiable face tied to that condition and that knowledge.

According to the identifiable victim effect, this is no minor detail. Individual stories have a far greater sway on our attitudes, intentions, and behavior than any long list of numbers, statistics, and facts. For example, if you were to see an ad for Save the Children with a picture of a single, emaciated Malian child named Rokia, you would likely donate significantly more to the charity (about 50% more, on average) than if you see a message listing the statistics about how many people are starving throughout all of Africa. Similarly, just knowing that Angelina Jolie underwent a double mastectomy after learning of her deleterious BRCA1 mutation will likely have a stronger influence on your awareness of this issue and support for genetic testing for BRCA than it would have had if you had simply learned about thousands of unidentified women who deal with these same issues.

So why do individual stories have such a greater pull on us than statistics — especially when, rationally, learning about thousands or millions of people being impacted by something should impact your attitudes and actions much more than hearing about just one?

First of all, these individual stories are vivid. Stories about people are graphic, full of individual details, and typically involve strong visual imagery. Similarly, our experiences with close loved ones are vivid; we know a lot about their lives and individual personalities, and we come into frequent contact with them. Decades of research has informed us that vivid information has a much stronger influence on what people think and believe than dull, boring statistics. Even if the facts themselves are supposed to be “shocking,” numbers on a page will never hit us at the same vivid level as a picture of a wounded puppy or a video of a crying little girl. Pure information will never really impact us in the same way that seeing something happen to our friends, loved ones, or an identifiable public figure will.

Secondly, in addition to being vivid and full of graphic details, individual accounts are emotional, and emotion is an invaluable component of persuasion. For example, men and women asked to donate money to support the charity March of Dimes would consistently donate more money if they were asked outside of a church as they walked in to confession (aka while they felt fairly guilty) than if they were asked when they were walking out of confession (aka when their guilt had already been resolved). We use emotions as a cue for what we should think and do. If you feel guilty? Do something good to resolve it. If you feel happy? Do something good to maintain that positive state. Without even realizing it, our emotions will sway our attitudes and actions — and no facts or numbers will manage to hit our emotions as strongly as an individual story of heartache and woe, or the thoughts, feelings, and lives of the people that we love and care about. In fact, as I’ve written about before, there are entire lines of research devoted to informing us about all of the ways in which our emotions impact our moral and political judgments. (Spoiler Alert: They impact them a lot.)

So what does a bunch of research on Mali, March of Dimes, and starving children have to do with Angelina Jolie’s Op-Ed today on her brave medical decision? Well, the main point of this effect is that it’s harder to work up the empathy and the emotional connection to care about numbers and figures to the point where they will actually sway your opinions and actions. It’s much easier to become emotionally invested in a cause when there’s a name and a face tied to it — especially when that name and that face belong to someone who is famous, well-known, and/or well-liked (hopefully, even if you’re still Team Aniston, you like Jolie enough that you would not wish her any harm!)

The more you can identify a single person being impacted by the issue in vivid, emotional detail, the more likely that person is to sway your attitudes. It happened with Ryan White, whose public struggle with HIV from age 13 to 18 spurred the US Congress to pass the Ryan White Care Act after his death, increasing the services available for people living with HIV/AIDS. It happened with Michael J. Fox, whose public struggle with Parkinson’s Disease is credited with raising public awareness of the disease to all-time highs, and whose foundation raises the most money each year within the United States towards finding a cure. Hopefully, something similar will now happen with Jolie as well. We can only hope that Jolie lending her name and face to awareness of the potential dangers of BRCA1 & BRCA2 mutations will make it more likely that women will get their own genes tested and, possibly, save their own lives as a result.

I truly want to thank Jolie for her bravery in coming forward to write about her double mastectomy, and I hope that others recognize what a great thing she has done for awareness of both breast/ovarian cancer and the potential of genetic testing for deleterious BRCA1/BRCA2 genes. However, now that you’ve read this article on why Jolie’s article was important…I must also warn you to be careful. New research has sadly shown that when people learn about the identifiable victim effect (as you just have by reading this article), it doesn’t always have the consequence that one might hope for. Of course, I would love for people armed with this knowledge to go out into the world and, aware of this bias, work up equal levels of passion for causes without such identifiable victims. But learning about the identifiable victim effect, as it turns out, can have the undesirable effect of actually decreasing support given to identifiable victims, rather than increasing support given to large-scale efforts. Apparently, when people learn about this, the first reaction is to correct for it by giving less to the victims rather than by giving more to the masses. So don’t let this fallacy sway your thinking! Maybe knowing about the effect of knowing about the effect will make a difference…

After all, the identifiable victim effect isn’t going anywhere anytime soon. Even Mother Teresa fell victim to it. As she put it, “If I look at the mass, I will never act. If I look at the one, I will.”

Of course, Stalin also noted that “the death of a single Russian soldier is a tragedy, [whereas] a million deaths is a statistic.” But let’s stick with quoting Mother Teresa.

For More On The Identifiable Victim Effect:

Dan Ariely: The Identifiable Victim Effect in Action

Andy Goodman (at Contributions Magazine): Stories or Data: Which Makes the Stronger Case?

Nicholas Kristof: Save the Darfur Puppy

Caveat:

Genetic testing can be incredibly expensive, and it is not necessarily advisable for all women to be tested for BRCA1 and BRCA2 mutations. Generally, it is only recommended that women get tested for mutations in these genes if they have a strong family history of breast or ovarian cancer. For more information, you can see the following resources:

http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA

http://www.mayoclinic.com/health/brca-gene-test/MY00322

http://www.ct.gov/dph/cwp/view.asp?a=3134&q=396624

References:

ResearchBlogging.org

Nisbett, R. E., & Ross, L. (1980). “Human inference: Strategies and shortcomings of social judgment.” Englewood Cliffs, NJ: Prentice-Hall.

Jenni, K.E., & Loewenstein, G. (1997). Explaining the identifiable victim effect. Journal of Risk and Uncertainty, 14, 235-257 DOI: 10.1016/S0167-6687(97)89155-X

Slovic, P. (2007). ‘If I Look at the Mass I Will Never Act’: Psychic Numbing and Genocide. Judgment and Decision Making, 2, 79-95 DOI: 10.1037/e718332007-003

Harris, M.B., Benson, S.M., & Hall, C.L. (1975). The effects of confession on altruism. The Journal of Social Psychology, 96, 187-192 PMID: 1186138

Batson, C. (1990). How social an animal? The human capacity for caring. American Psychologist, 45 (3), 336-346 DOI: 10.1037//0003-066X.45.3.336

Image Credits:

Images of Angelina Jolie by Gage Skidmore via Wikipedia. Available under Creative Commons Attribution-Share Alike 3.0 Unported License and Creative Commons Attribution-Share Alike 2.0 Generic License.

Image of Michael J. Fox by Thomas Atilla Lewis via Wikipedia. Available under Creative Commons Attribution 2.0 Generic License.

 

This is a slightly edited version of a piece that I originally posted in March 2013, relating to Rob Portman’s decision to support marriage equality after learning that his son is gay. You can see the original post by clicking the From The Archives icon on the left.

Melanie Tannenbaum About the Author: Melanie Tannenbaum is a doctoral candidate in social psychology at the University of Illinois at Urbana-Champaign, where she received an M.A. in social psychology in 2011. Her research focuses on the science of persuasion & motivation regarding political, health-related, and environmental behavior. You can add her on Twitter or visit her personal webpage. Follow on Twitter @melanietbaum.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. DanBrook 1:24 pm 05/14/2013

    Angelina Jolie’s decision is fine for what it is, and I applaud her for proactively looking out for both her health and the interests of her children, but breast cancer (as well as other cancers, including prostate cancer, plus heart disease, stroke, diabetes, gout, kidney disease, hypertension, etc.) can be better prevented, halted, and even sometimes reversed, with a low-fat whole foods plant-based diet.

    As a bonus, this diet has many other benefits as well, not only for your health (without surgery), but also for public health, for the animals, for your spirit, and for our environment.

    I urge you to watch
    http://www.ForksOverKnives.com

    and to peruse
    Eco-Eating: http://www.brook.com/veg

    Link to this
  2. 2. drafter 3:45 pm 05/14/2013

    DanBrook
    That diet didn’t help Steve Jobs and he admitted that to a close friend.You also mentioned gout and kidney disease, some people were born with a blood dissorder, that diet has zero effect to those issues. It is so tiresome when people who know nothing of others medical history think it’s their job to tell them what to eat. A balance diet and discuss your own issue with your own doctor and not the latest fad.

    Link to this
  3. 3. vagnry 3:57 pm 05/14/2013

    My wife, whose grandmother and mother both died at around 50 from breast/ovarian cancer was found to have Brca1 about 10 years ago, several years after she had breast cancer and had a mastectomy of the “infected” breast.

    She decided not to have another mastectomy, which is much easier to find/diagnose/cure early on, but to have her Fallopian tubes & ovaries removed, and we thought she was home free!

    A year after that operation, she fell ill again, ovarian cancer. It turned out that some of the foetal cells can develop into ovaries or to other parts of the abdomen.

    So, neither Angelina Jolie, nor anyone else, can be guaranteed to be saved, but it sure reduces the risk, and I applaud that she made it public, as I think hardly anyone has ever heard of brca1/2, or for that matter, other hereditary cancers.

    And, now 11 years after my wife was diagnosed/operated/chemoed etc., she is sitting right next to me.

    Link to this
  4. 4. JoeJeffrey 5:50 pm 05/19/2013

    There’s another, very powerful, effect that this article did not discuss: having a very high status individual do something previously taboo is often a very, very powerful social change initiator. And when that person does something that contradicts the whole “victim” image, as Jolie has done, the effect is heightened. In effect, Jolie acted as the opposite of a victim: someone who saw a serious risk to her life and took a huge step to avoid it. By her action, she became a symbol of what women can do, when necessary, instead of being victims.

    Link to this

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