Fear marketing is about creating a threat to perceived safety.

In order for someone to feel truly threatened, they need to feel…

• Perceived vulnerability (aka, “How likely is it to hurt me?”)
• Perceived severity (aka, “How bad will it hurt?”)
• High level of self-efficacy (aka, “I have the ability to control / change”)

But here’s the thing about fear in healthcare. Just like a scary movie, it appeals temporarily but rarely does it stick with us long enough to change our behavior – often because it’s used without much thought to how we communicate the above 3 variables. OR it creates SO much fear that we lose the ability to think creatively and flexibly. 

Why? 

It’s not emotionally (or physically) sustainable to live in fear. So to protect ourselves, we often minimize the risk of significant fears saying, “that will never happen” or “that’s not real.” As time goes on, the perceived severity (and susceptibility) begins to decline. Think about it like a scary movie – for a period of time we sleep with the lights on and jump at every noise. But as time goes on, we come back to the present reality that Regan (Exorcist) is not going to walk down our stairs…

I see this often in silent chronic conditions such as high blood pressure, high cholesterol, and diabetes – people get the diagnosis and make great changes out of fear. But as time goes on and “nothing happens,” the fear subsides and they return to their previous lifestyle. 

When you feel like the options for change are out of your control (or worse than the fear itself), we feel helpless.

Eating disorders are a prime example. Clients are aware of the consequences of starvation and/or purging, but the uncertainty that comes with challenging those behaviors is far more terrifying.

Additionally, when we use fear in a chronic condition, it can make it hard to live the REST of our life – we feel like our only being is that condition. I often see this in diabetes or food allergies/intolerances – there’s so much fear around the danger of certain foods, that it becomes impossible to consider food as a joyful experience. That leads clients to reduce the perceived susceptibility or severity of the fear in order to continue receiving joy (or resort to disordered behaviors). 

Finally, fear or lack of knowledge make us take zero action. For example, when you tell a client that fresh vegetables are better than frozen, they feel that’s the only option they can choose. But when they can’t afford the fresh vegetables, don’t have access to them, or don’t have time to prepare them we end up with NO vegetables which is WAY worse than frozen or canned options. 

How many times did your mother tell you, “If you keep making that face, it will stick that way.” The first few times she said it, you heeded her warning. When you realized it wasn’t going to happen (or humanly possible), the threat stopped working.

“If you smoke, you’ll get lung cancer”
or
“if you drink soda [as a diabetic], your leg will fall off”
or
“if you eat a hamburger, you’ll have a heart attack.”

People hear these warnings and listen…for a bit. But as time goes on and nothing happens, they put less credibility in the source. When people want to continue the behavior, they’ll find any story / example they can to discredit the original source. You can always find an exception to the risk to normalize the behavior. 

Eg, “my uncle smoked a pack a day for 40 years and died at the age of 90”
OR
“my cousin had diabetes and ate donuts every day and she’s still here”
OR
“my mom had a drink every day and she’s fine” 

Additionally, the more extreme the threat, the less likely people are to feel like it will happen to them – because it doesn’t feel relevant to them.

Eg: Telling a teenager that they’ll get addicted to drugs goes right over their head.. That’s because a teen’s brain isn’t fully developed – they don’t fully process risk / consequence. This gives them a false sense of control and makes them feel indestructible to long term risks. 

In the end, the more you resort to extreme threats, the more likely your audience is to tune out. 

Humans are more likely to turn to rewarding experiences more often than they run from fear. In my experience (and most research), values win. If the current social approval of a tan is more rewarding than the potential risk of sun cancer, we’re going to skip the sun screen.

It’s helpful to re-frame our messages to helping people get more out of life – not less.
People tend to gravitate towards behaviors that increase their feeling of connection to others and/or give them pleasure / reward. So before you threaten a patient with a loss of limb, consider finding out what matters most to them and reframing their health behavior in that light.

“If you practice walking every day, you’ll be able to move easier with your grandchildren”
OR
“If you incorporate more produce, it might be easier to go to the bathroom.” 
OR
“If you move more, you’ll sleep better at night”