I'm writing this post from a coffee shop. There are big windows that overlook the sidewalk, and tables on the sidewalk. Sitting at one of these tables is a woman who I suspect is mentally ill. Seeing her has gotten me thinking about, among other things, behavioral economics and the need for connection.
A post yesterday in yesterday's Psychology Today blog made this point as well. The post tells the story of a man who has an illegal business selling pirated downloaded content. For a variety of reasons, he considers, and to a limited degree, pursues getting a legitimate job. However, contrary to all reason, he decides to stay in his existing, shady situation. Why? Well, as the post notes,
[H]e described how he recently attempted to find a regular, legal job.
But giving up the illegal business he had created and nurtured for five
years was very difficult for him.
A second aspect of loss that he described was that of his social
network of customers and friends who are linked to him through business
ties. He proposed that the bond between himself and his customers is
much deeper than the traditional retailer-consumer relationship. After
all, in his line of illegal work the relationships have to involve more
trust, reciprocity, and friendship. All of this makes it even harder to
leave that circle.
This man eventually gave up his search for a legal job and went back
to his life of crime. He knows his decision might lead him to prison.
But he was simply unable to accept the loss of his business and social
The point here is that the man's unique situation created an unusually strong need for trust, and unusually close bonds — strong enough that the man was willing to risk jail to preserve them. I think illness works the same way.
The woman on the sidewalk is not a complete mess — she's not your stereotypical bag lady. She does, however, have a large pile of books, papers and so on, that have been heavily highlighted and annotated, and she's going through them with the frantic, angry air someone who's mentally ill often has. She's talking to herself. It's uncomfortably chilly out, but she's out there. And, of course, she's alone. I'm guessing she's alone a great deal.
Illness does that. It's kind of a side effect. In the case of this woman, I'm going to assume that her behavior has alienated people and prevented her from spending any time with anyone. But the same thing happens with other ailments, particularly chronic ones, although the mechanism is a little different. Over and over and over again, we have learned and heard that patients with Crohn's disease, or MS, or cancer, over time, feel absolutely isolated.
They believe nobody really understands their situation. And they're probably right. Unless you personally experience it, it's almost impossible to understand what someone with Crohn's goes through on a regular basis. The result is that patients tend to withdraw. They tend to disengage from other people. this is tragic in two ways. First, of course, being progressively alienated from other human beings is a terribly difficult way to live. And second, they tend to disengage from their disease, which often really causes their adherence to deteriorate.
And under these circumstances, when they do have contact, if that contact appreciates and understands their situation, as with the illegal downloader of the Psychology Today post, there is an unusually strong bond, and an elevated level of trust. And more and more, this trust, which used to repose in the physician, is now being transferred to the brand, to the pharma company that presumably understand what the patient is going through, because they're helping him cope with it.
It's all powered by trust. Our responsibility is much greater than simply helping patients manage their disease. We're also responsible for helping them stay connected. This gives pharma marketers unusual impact, and unusual power. Nobody's isolation is lessened because they buy an iPod. But for someone fighting breast cancer, regular, relevant communication from the drug company that's helping them stay alive is also helping them, in a small way, to stay connected.
We can't ever forget that.