Why Don’t We Listen to Health Warnings?

Social psychologists have studied how individuals process information that is not congruent with their sense of self. One area of study has been how individuals interpret behaviors that may run contrary to their sense of self; or, when their self-image or integrity is threatened. Initially the theory of self-affirmation focused on how people attempt to regain self-worth after self-integrity has been threatened (Steele, 1988). This type of reaction can be maladaptive in that by avoiding or processing information in a defensive manner one avoids learning from or through threatening experiences.

Interestingly, self-affirmation may also be a defense mechanism people use to avoid information about unhealthy behaviors. The digital age affords a plethora of methods to literally bombard individuals with health messages encouraging us to be proactive. Why then are so many of us non-receptive to the information?

Lack of receptivity as a defense mechanism to threatening information

Self-affirmation theory suggests that people are motivated to protect their sense of perceived self and integrity; in turn, that protection can lead to defensive responses. Clearly, messages about unhealthy behaviors that hit home (e.g., eating high-fat foods, not exercising) can arouse anxiety and be followed by “that’s not me.” This latter response is particularly likely if the person is not experiencing overt medical problems. In such situations, the health messages undercut one’s self-perception as “healthy.” In order to maintain their sense of self, the individual may respond defensively by rejecting, denying, or avoiding the information.

Lack of receptivity may be due to how the information is communicated

How the health information is presented may also offer some possible explanations for why a person doesn’t respond to the message, such as:

• Being ambiguous and not clear in telling us what to do.
• Being non-reassuring.
• Being presented in a frightening way.

Ambiguous messages may inadvertently forward a defensive or non-responsive reaction. That is, the individual can adopt the position that because there is no certainty about the issue, “Why should I change my behavior?” This attitude is enhanced further not only if there is no consensus among credible sources regarding the message, but if there are clear conflicting opinions (Klein, et al, 2015). Alternatively, exaggeration or doomsday messages about the risk of danger may also lead to a defensive posture. For example, if the message is presented in a manner that makes one feel helpless or view it as an attempt to “scare us straight,” the individual’s reaction may be to dismiss or resolve the distress by ignoring it or viewing it as “overkill.”

Using self-affirmation to promote positive health-related decisions and behavior

Self-affirmation does not have to lead to maladaptive defense mechanisms. In fact, when there is information that creates a dissonance between who we believe ourselves to be and our unhealthy behaviors, it can create an opportunity for positive change. There is an increased inclination to change and a reduction of defenses if the message is “packaged” to address core strengths and values. Taber, et al, (2016) note that the positive attributes for being receptive to health information are those underscoring the elements of morality (e.g., to protect self and others), and the ability to be in control of important issues (e.g., the health of one’s family). By focusing on these positive features, one’s responsivity to positive change is increased and the threats and defensiveness are lessened (Epton, et al., 2015). Consequently, the individual is primed to be redirected from defensiveness, worry, and concern about their self-image and is able to deal with the matter at hand or to even help others (Taber, et al., 2016).

Self-affirmation may even alter our brain’s response to health messages. One study found that if individuals focused on their positive self-worth when viewing health-related messages, not only did they have greater brain activity in areas that process and interpret information (prefrontal regions), but would also “see otherwise-threatening information as more self-relevant and valuable” (Falka, et al., p. 1979).

Falka and colleagues (2015) describe how self-affirmation is a psychological technique where if one affirms core values before experiencing a possible threatening message, the person will feel less threatened and more receptive. Such reactions may be related to one’s desire to protect and reinforce their perception of themselves as “good and appropriate,” and as “one who has self-integrity.” Because of this solid and grounded sense of self, when their adequacy is threatened, they rely on their adaptability and inner resources, thus responding less defensively (Epton, et al., 2015).

Self-affirmation can also help in managing one’s uncertainties, fears, and response to treatment

It is important to recognize that for many health-related issues, there is no absolute certainty in how to avoid or treat them. A difference of opinion among health professionals is not unusual, and so there may be no clear direction or option to choose. Self-affirmation may play a significant role for the individual in promoting responsibility for addressing ambiguous health information. When predictability and control are threatened, self-affirmation can marshal one’s important attributes and characteristics to handle the situation. This reaction can reduce defensiveness, emphasize adaptability, promote self-integrity, and encourage one to be proactive. Therefore, the individual may be more likely to ask questions, seek out health information, risk appearing uninformed, get a second opinion, or become better aware of their circumstances (Taber, et al., 2016). Self-affirmation enhances not only the interactions one has with medical personnel, but their receptivity to treatment.

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Another emotional response that can impact the effectiveness of health-related information is anticipated regret. If a person believes that they will experience regret for something they either will do or will not do, it may impact their current behavior. This form of expected self-blame can be a strong catalyst for encouraging healthy behaviors (van Koningsbruggen, et al., 2016). This is especially salient for people who tend to be future-oriented. By anticipating regret, one is less likely to become defensive and more receptive to change.

As a result of the many scientific, medical, technological, and communication advancements, we live in an unprecedented time regarding the dissemination of health information to the public. Because the breadth, depth, and continuing evaluation of health information are so great, many of us may feel overwhelmed and anxious about choosing the right direction to take regarding our health, especially if there is no clear consensus. Thus, self-affirmation can be a crucial psychological element for encouraging and maintaining healthy behavior.