Archive for the ‘Social Behavior’ Category

Labels Graphic

“The moment they diagnosed me, I disappeared.” This was the striking statement of a man who went extremely public with his experience of carrying brain cancer. By “disappear” he meant that he was now labeled by his disease “brain cancer.” His name, his history, his persona all evaporated. Isn’t a terrifying diagnosis enough? Should patients have to lose themselves as well? It is ironic that a label, which should by definition offer identity, instead often strips it away.

Let’s dispense with the obvious: labeling others is dehumanizing and fails to recognize the complexity and full humanity of each person. We shouldn’t label others, but we do. An interesting social experiment was carried out recently in which 6 strangers met each other for the first time in the dark and had a conversation. When the lights were flipped on, their jaws dropped. The participants were shocked at how different each person looked from the perception each had created in their minds. The participants included a heavy metal rocker dressed in a suit and a tattooed professor.

But is moving beyond labeling even a winnable battle? Our brains are designed to categorize. It is how we make sense of the world. It is helpful to be able to assess quickly who is a friend or foe, for example. Even the most intense politically correct “training” will never stop our brain from forming an instant impression, that may in fact be false or superficial. But maybe this is not the point where intervention is needed. We all label and will continue to do so, but can we become “fluid labelers”, ready to release a false impression in a second and embrace the dissonance that comes with the unexpected image? I once had a Chemistry professor (what do you picture?) who looked and sounded like a football coach. To hear this bald headed, stocky, brash teacher talk about electrons with the intensity of a Super Bowl final pep talk was wonderfully bizarre. It shattered every label I would have placed on him. And I just chose to run with it. Chemistry class was never the same.

But to be fluid with labels is to leave your brain naked for a moment. Bereft of convenient categories how will your brain feel at ease? I would submit that this discomfort is healthy and in fact important. I once saw a patient with liver problems instantly ascribed to alcoholic cirrhosis simply, because he presented with alcohol on his breath. He was not in fact an alcoholic; his liver disease had another cause entirely but he was quickly labeled. Jerome Groopman tells similar stories in his excellent book How Doctors Think about how medical mistakes are made by labeling patients in two-dimensional ways.

All this does not mean we should ignore impressions. We should look out for subtle clues in people and certain categories make sense. The real question is not whether we label but how tightly we hold onto that label. There is a word for refusing to let go of a label no matter how much we know . . . prejudice.

And this is the exact place I was going to end this blog post, but I had to get all over-achieving and look up a few quotes on labeling! Most of what I found was predictable, in the vein of not letting others define you, resisting society’s labels and so on, an important point of view, of course. But somewhere in the middle of all those quotes was this:

“I have always been taught to be proud of being Latina, proud of being Mexican, and I was. I was probably more proud of being a “label” than of being a human being, that’s the way most of us were taught.”

Erin Gruwell, The Freedom Writers Diary

Erin’s words stood out because she is not talking about other people’s labels, she is talking about her own. Can our own labels be just as problematic, maybe even more so because they seem benign? I’m extremely proud of my Kenyan and Scottish heritage. What’s wrong with these labels? Nothing except, as Erin reminds us, when these labels become more important to me than the humanity I share with people who don’t happen to Kenyan, or Scottish, or American or in medicine, or in Theatre, or . . . what’s your list?

What makes you say “Yes”? I have begun my journey into the book Hidden in Plain Sight by Jan Chipchase. So far, Chipchase is interested in how we respond to new things and what leads us to adopt or reject them. He argues that adoption is not a one step process but rather a 5 step sequence: Awareness-getting to know about the existence of new things  Interest-wanting to find out more Evaluation-imagining one’s life with this new thing Testing- giving it a trial run and finally Adoption- a commitment to use. He further argues that we can be early adopters who are typically, but not always, innovators or the young and highly educated; medium stage adopters who are slightly older, perhaps less educated and late adopters or laggards and flat out rejectors.
Why do you adopt some things and reject others? The biggest factor seems to be what everyone else is doing. And why does this matter? For me, it matters because I want be part of the effort to effect widespread change in healthcare delivery and knowing what makes people behave a particular way seems central to that vision. Take a simple example: I was skeptical about joining Twitter for a long time. I wondered what was really worth saying in 140 characters. It seemed superficial and an excuse to spout fluff about bacon for breakfast (although, it should be noted that bacon is indeed delicious). Then, I found out people and organizations I respect were on it, and some of the dynamic ways it was being used and I began to reconsider my opinion. I have since joined Twitter and now integrate it in both personal and professional areas of interest. But did I simply have a limited understanding of Twitter or was my perception altered by those around me, even though the platform stayed the same? What was the “reality” of the usefulness of Twitter?
On the subject of reality, can we take a quick detour for a moment? I heard something thought provoking this week from a cognitive scientist who argued that we often do not perceive reality as it really is (optical illusions, misread social cues etc) but that this may not actually be a bad thing in every instance. This scientist ran some evolutionary experiments on his computer and found out that accurate perception of reality did not necessarily translate to increased survival. Is there an evolutionary benefit to believing certain illusions? Are we witnessing the triumph of tact?
Truth matters of course and I don’t think anyone would argue for living in a fantasy world defined by illusion, except perhaps actors, but that’s the job;) Is it in our benefit (or others’ benefit) to know everything accurately and share everything accurately at all times? For the die-hard “tell it like it is” types, this question may seem obvious, but consider the Alzheimer’s patient who keeps forgetting her husband has died. Every time we confirm that he has, she feels fresh grief. The next time she asks “Is my husband still at the store?” Is “Yes” more compassionate than breaking the news of his death once again? What happens when reality and compassion clash?
Or consider this headline from BBC Health this week:
Virtual reality could help stroke patients recover by “tricking” them into thinking their affected limb is more accurate than it really is, researchers find.” In this case, an illusion is central to the therapeutic process . . .
Stroke Arm

The virtual reality arm appears to move faster and more accurately than the real arm. Courtesy of BBC Health

Perhaps the guiding principle is that we should be more interested in meeting people where they are, than where they should be. This does not mean abandoning timeless ideals of truth and justice, but it does ask for a certain nuance and compassion in how we apply these lasting principles.