Pharmaceutical Market Europe • June • 13
POLICY AND PUBLIC HEALTH
Maybe we can learn something from the Golem and Pygmalion effects
The Pygmalion effect (or Rosenthal effect) describes the scenario in which someone else’s high expectations improve our behaviour and, subsequently, our performance in a positive manner. It suggests that we do better when more is expected of us. Much has been written about this psychological and behavioural concept over the last half-century and it is widely accepted that the Pygmalion effect exists in academic, workplace and healthcare settings. You may be familiar with the more colloquial description of this as a self-fulfilling prophecy.
There is a counterpart to the Pygmalion effect, and it is known as the Golem effect. This behavioural construct suggests that those with negative or low expectations will elicit behaviours that impair the performance of others and make others themselves produce negative behaviours.
The myopic approach of governments around the world during COVID-19 has been a confusing tug of war between the Pygmalion and Golem effects for the general public. Perhaps it was not purposeful, but its effect has been real.
The idea that we would be able to manage the virus with little direction or input was never going to happen. Governments and public health officials never communicated a steadfast belief in the general public’s ability to successfully manage the behavioural health measures required to prevent transmission. Or to understand and act upon the scientific information that was being released.
Instead, they gingerly cajoled us all with nudges and, in doing so, explicitly demonstrated that they were unwilling or unable to distinguish between the importance of high and low expectations and recognise the important behavioural lessons, namely improved (or impaired) behaviour and performance.
Perhaps it was all for the best, you say. In those early days, people couldn’t really be trusted to make sense of all this information. Even the experts were confused. This was a novel coronavirus that had never been seen before. You may be thinking that setting low or negative expectations wasn’t such a bad thing. And besides, you say, a lot of what happened in those early days can be chalked up to miscommunication. Or you may cite health literacy as a mitigating factor and not expectation setting as the culprit. And, of course, we quickly suffered from public health fatigue, which naturally impacted our behaviour.
We bumped up against the ‘invincibility complex’ that people disdainfully displayed in the face of the virus in the early days. It won’t happen to me. I won’t get it and if I do, it will be fine. I’m too strong for this thing.
All of these things are true. But governments and public health officials missed a golden opportunity to include behavioural health scientists as part of their committees and task forces aimed at dealing with the spread of the virus. Or if they did, they ignored them.
Governments and public health officials set high expectations about the safety of outdoor activities in the context of infection risk and then started to tell people that they couldn’t go for a walk without wearing a mask.
They set high expectations about properly ventilated spaces and the role of such spaces in preventing or blunting viral transmission. And then they didn’t upgrade any of the old, decrepit buildings with new ventilation systems.
They set low expectations about the virus being ‘seasonal’ and they told everyone that wave 1 will be followed by a wave 2. And then they told them again that wave 2 would be followed by wave 3.
They told them that this virus would thrive in the winter season in the northern hemisphere. Clearly something went wrong because wave 2 and wave 3 were worse than wave 1.
They set high expectations about herd immunity and its role in beating COVID-19. They said herd immunity would be reached at 70%. No, wait a minute, it will be at 80%. Now, most of the epidemiological community concurs that herd immunity is unlikely, which has impacted behaviour in terms of inoculation uptake.
Perhaps worst of all, they set high expectations for the vaccines. Despite the best efforts of the vaccine manufacturers, the trial results are what they are. There are still people who I speak to regularly that think a vaccine with an efficacy in the high seventy per cent range is a ‘bad’ vaccine compared to one with an efficacy in the mid-ninety range. This list of high vs low expectation items could go on forever.
My message is not that governments and public health officials shouldn’t have talked about these things but that they needed to have more urgency in understanding behaviour and context. Hopefully there won’t be a ‘next time’. But if there is, the Pygmalion and Golem effects should play a central role in guiding our approach.
Rohit Khanna is the Managing Director of Catalytic Health, a healthcare communication, advertising & strategy agency. He can be reached at: rohit@catalytichealth.com