If you want to change behavior, avoid shame
why we actually need creativity in a crisis
Note: this piece initially ran as a brief op-ed in the Chicago Tribune on July 6, 2020. This post is a fuller version of that text.
“Shame is not going to save us from a pandemic.”
These were the words of my friend and former colleague, typed to me via Facebook chat in late April from her new home in Switzerland, where the coronavirus situation was much further along than in the U.S. We were discussing an alarming trend in online behavior: the tendency to point and shame when others fail to respond as seriously as you’d like to the latest public health guidance.
And trust me, I get it. In fact, I’ve done it. I couldn’t help but fume a few weeks before our conversation when I witnessed a group of my neighbors huddled together on a front porch to escape a light rainshower, households mixing (!) barely a foot apart. Now, it’s July, and many of us are applauding the current Black Lives Matter protests, even as we recognize their potential for viral spread. How quickly public opinion can shift when moved by urgent demands. (Indeed, while some have accused the political left of hypocrisy for how quickly many have pivoted on this particular point, it’s unsurprising that those fighting for Black lives would be easy and unfair scapegoats for spikes in viral spread. Thankfully, common sense — and data — tells a different story.)
As we progress into the next era of our human relationship to the coronavirus, there will be new demands on our behavior and no doubt new attempts to shame those who behave less-than-perfectly. As I imagine how such patterns might play out in the coming months, I recall what I have long known remember what I have long known and practiced as an educator: that shame is not only a poor way to change behavior, it’s actually counterproductive. For almost ten years I’ve worked with the Illinois Caucus of Adolescent Health (ICAH) as a sex educator. There, I am a co-founder of the FYI Performance Company, which uses theatre-based strategies to uniquely reduce shame in sexual education. Together, we’ve created plays, workshops, curriculum, and even written a book on how theatre-based strategies can uniquely reduce shame in sexuality education.
Shame is not only a poor way to change behavior; it’s actually counterproductive.
As anyone who’s talked to me in the last few months knows, I’ve been thinking a lot about how the parallels between this situation and the ones I’ve faced talking to young people about safer sex. After witnessing the conversation shift over the last few weeks from “what prevention strategies are needed?” to “how can we help people sustain these strategies?” I’ve come to believe that creative tactics are going to be essential in keeping people motivated through some really tough lifestyle changes. As the prominent surgeon Atul Gawande has argued, “Culture is the fifth, and arguably the most difficult, pillar of a new combination therapy to stop the coronavirus.”
I want to start by looking at the kind of messaging we’re seeing currently: what’s working, what isn’t, and how we might think differently about the way we talk about reducing harm in this moment. Part of that process means accepting (and working with) some basic truths about human psychology.
“Just wear a mask” or, how masks are kind of like seatbelts and condoms
In April, when the CDC reverted from saying that masks for the average person are unnecessary — and perhaps even harmful — to recommending universal cloth face coverings, I was surprised at how quickly people took this new recommendation to heart. And how quickly they turned on those who didn’t.
While the science had initially seemed murky (as it often does at the outset), eventually enough studies pointed to a substantial benefit for the use of face masks. That message then got simplified for ease of implementation: “just wear a mask!” “What’s so complicated about that?” I heard from so many peers (even as public health officials continued to waffle on the subject).
The trouble is that we’re people and so it is complicated (see: the history of seatbelts). There are lots of reasons why people might prefer not to wear a mask, whether or not we believe those reasons are justified: they’re uncomfortable, we’re not used to them, we’re unsure where to get them or how to clean the, etc. Or perhaps (as I’ve wondered after seeing so many men refuse them) we even find them im-masc-ulating.(Where’s the headline “Mask for Masc” when you need it?)
It has struck me how the conversation around masks resembles the way we might talk about something like condoms. I can support condom use while also recognizing that it can be hard to persuade people to use them all the time. And that, a lot of the time, it’s not really my call. In fact, there are tons of situations in which condoms — or similar barrier methods — can be effective but for which many people don’t regularly use them (e.g., during oral sex).
Also like condoms, masks are only helpful if you use them properly. Walking around with the mask hanging out below your nose, or pulling it down to talk to a friend, well…it’s sort of like not putting the condom on all the way — it doesn’t do much good.
Where logic fails to motivate
The truth is that while many of us recognize the importance of masks (and condoms) in keeping us safe, there are all kinds of reasons why people might prefer not to wear them. And logic alone has never been enough to change habits.
Copious psychology research tells us that even when we know what the logical choice is, we don’t always oblige, especially if our basic needs (comfort, connection, security) go unmet. So when we call people out for not behaving logically (e.g., refusing to stay home or wear a mask) we are swimming upstream, trying to overcome emotional inertia.
One of the most useful frameworks I’ve come across for understanding the peculiarities of human behavior is called the elephant and the rider, and it comes from NYU psychologist Jonathan Haidt, further explicated in the book Switch: How to change things when change is hard (by Chip and Dan Heath). Essentially, the metaphor suggests that persuading someone to change is like trying to motivate a person riding an elephant (or a camel, if even metaphorical elephant riding makes you sad).
The problem is that such reactions are rarely logical.
In the framework, the rider represents our logical brain, the part of us that wants to know exactly what we should do and why. We can already see how the rider is taxed in our current moment. The human brain struggles with nuance. When people become cognitively overloaded — as we all have with the constant barrage of news updates — we tend to default to whatever requires the least effort. What’s more, many of us are probably experiencing cognitive whiplash from the ever-changing public health recommendations (should we wipe down our groceries or not??). As such, the rider is stumped.
This is where the elephant (or camel) comes in. The animal side of the metaphor is the emotional brain, which can easily become overwhelmed by logical arguments. The animal will only move if it can sense a reward or the meeting of a basic need like love or comfort. If such needs are not met, the animal may cause us to act out in counterproductive ways.
What’s more, even if we do manage to persuade someone to just do as we say, the emotional brain might still get in the way: a phenomenon called risk compensation occurs when someone actually engages in more risky behavior as a result of experiencing some measure of protection. (For example, in Switzerland, where my friend lives, the government is not mandating masks, and as in many other European countries, bicycle helmets are also not mandated and are less common.) While the impact of such compensation is usually less than the protection itself (e.g., helmets and masks are still ultimately a good idea!), risk compensation may be responsible for the tendency of people to drive a bit closer to the cyclist who’s wearing a helmet than the one who’s not, or perhaps to forgo proper social distancing while wearing a mask.
From ‘caution fatigue’ to harm reduction
After what my friend said about shame, it struck me that we needed a different kind of conversation. The first step, I believe, is cultivating empathy: we have to recognize that not everybody is going to play by our rules and that sucks. Unlike with our sexual partners, we have less control over who we interact with in our daily life — at the grocery store, on the street — and so the choices people make about prevention in a pandemic have a more apparent public impact than the ones we each make in our bedrooms. Still, the two situations bear quite the resemblance. And in each, we can start by recognizing that most people are doing the best they can in a situation with few good options to choose from.
As Julia Marcus’ recent article on quarantine fatigue demonstrates, there is a real need to think beyond shame and consider an approach known in health circles as “harm reduction.” In this framework, we’re able to say “look, here is the gold standard for prevention, but if that doesn’t work for you, if you need to do things differently, here are some ways you can lower your risk.” Sex educators like myself have been advocating this for decades. Harm reduction has a particular history within certain queer and drug-use communities, in which it can be difficult to talk about the reality of certain behaviors without facing stigmatizing and judgment. (Needle exchange programs, which date back to the 1970s, are a prime example of how a harm reduction approach can improve public health outcomes without relying on the total elimination of potentially harmful behaviors.)
The core idea behind risk reduction, as Marcus reminds us, is that not all risks are not created equal. In sex or drug use, as in a pandemic, there are higher and lower risk activities. For instance, going for a walk outside is different than visiting a friend or throwing a houseparty, just in the same way that sex with multiple partners is different than sex with one. But this is where I think we have to be careful with our own moral superiority. Harm reduction is not about saying “my way is better than yours.” (As the Canada-based writer Clementine Morrigan pointed out in response to remarks from the Quebec minister of public health, we can show our support for lower-risk behaviors without judging or shaming folks who — for any number of reasons — make different choices.)
And while I don’t want to absolve anybody of the collective responsibility or shared stakes here, I think we have to avoid the kind of all-or-nothing thinking that can emerge when we feel restricted by a playbook of choices that don’t reflect our reality or serve our needs. (Another psychological phenomenon, caution fatigue, claims responsibility for the erosion of careful behaviors over time.)
Another core aspect of harm reduction approaches — and a key piece of good sexuality education — is informed consent. Consent has entered the global conversation in a big way the last few years, thanks largely to the activism of the #MeToo movement. But too many people still misunderstand consent as a kind of permission-getting. I find it more helpful to think of consent as a process of ongoing exploration and negotiation. Good consent practices recognize that not only do different activities carry different levels of risk, but we get to change our minds about what kind of activities work for us at any time.
I recently had an experience at a protest where a photographer suddenly came up to me and stuck his camera right in my face — not something I had signed up for! I waved him away and must have looked shaken because a woman marching near me gave me a look and gestured as if to say, “do you need an exit route?” I felt so cared for in that moment and grateful that this woman wanted to make sure I still felt good participating.
We say “informed” consent, because you have to know what you are agreeing to and how it will affect both you and those around you. After all, harm reduction doesn’t just mean we do whatever we want; it involves active consideration of possible risks and making conscious choices that allow us to participate in ways that make sense for our personal circumstances and preferences.
After all, harm reduction doesn’t just mean we do whatever we want; it involves active consideration of possible risks and making conscious choices that allow us to participate in ways that make sense for our personal circumstances and preferences.
When we shame, we discount people’s ability to make informed choices. Research has consistently shown that such messaging — the “abstinence-only” cadence of “just wear a mask” or “stay home” — can actually lead to less-safe behavior because it occludes a very real set of lower-risk options. (It’s well documented that abstinence education doesn’t lead to less sex; it leads to less safe sex.)
But for adults who are themselves often afraid or confused about safer sex, it seems easier to say “just don’t do it.” Similarly, exhausted medical experts and governmental leaders might be tempted to double-down on punitive measures, such as Chicago mayor Lori Lightfoot, who last month threatened to arrest anyone in violation of the order to stay home (a course of action which, while potentially deterring, was never really about safety). That move was a stark contrast from her earlier — and I would argue, more effective — strategy of putting together a comedic PSA offering ideas for how people might make use of the time at home. (Illinois’ Governor Pritzker also followed suit with a video in which he warns penguins at the local aquarium to stay 6 feet apart.)
How creativity inspires agency
As states are reopening — and in some cases shutting down again as cases surge — finding creative ways to reduce risk will be critical. Creativity allows people to expand their thinking, try on new possibilities, and act without fear of judgment. From documents circulating on how to stay safe while protesting in a pandemic, to the vital mutual aid networks that have sprung up in cities across the nation, we’ve seen the ability of communities to invent their own working solutions.
These projects can feel personal, even pleasurable — like the look of pride on my friend’s face when she sports her favorite cat mask, sewn lovingly by a relative. When someone speaks to us in a language we know, we are more willing to listen.
This is where FYI excels. We have been successfully reaching young people throughout Illinois for more than 10 years. We use creative strategies in our programs not only to increase engagement, but also to connect with youth on an emotional level: at the same level as our desires. We provide facts, yes, and we also acknowledge the role that pleasure plays in sexual decision-making. We use game boards, improvised storytelling, and other creative tactics to help young people step into their own power as they practice making thoughtful decisions about what kinds of sex practices will work for them and their partners.
When someone speaks to us in a language we know, we are more willing to listen.
There are no easy solutions to the current challenges of the pandemic. There’s no silver bullet that will suddenly persuade everyone to heed medical expertise. And even if there were, we’ve seen how those recommendations change more quickly than most people can adapt to the new conditions. In fact, they are still changing to this day.
We need up-to-date medical advice in this moment as much as we need good leadership. But if we stop there, we miss out on a key resource that might help us connect with our communities in authentic ways. At FYI, we’ve learned that creativity is a tonic for shame.
A harm reduction framework infused with creative thinking allows us to meet evolving circumstances without shame, and to move forward in ways that acknowledge our humanity and allow our communities — particularly those most impacted by this crisis — to thrive.
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