Peter Slattery

I think the BIG BIG issue of alcohol consumption is finally starting to get some air time in Australia. And so I am weighing in with an opinion or two.

There have been some ads on TV aimed at binge drinking teenagers. They are two part ads, one aimed at under 18 year olds and the other at over 18 year olds. I have no doubt that the ads are well-intended and probably well researched. And I still have some concerns about them. So let me take a bit of a tour through human behaviour and advertising. And I am happy to hear other opinions about all this, and I am happy to hear about any research in this area too which might help us get this right.

My starting framework is the following. If we are going to try to persuade (and that’s what TV ads aim to do)…if we going to try to persuade people to act well either for themselves, for others, or both…then certain ingredients need to be present. Let me quote directly, and it’s only one source of course. In this case it happens to be from Bruce Berger, Ph.D.
Alumni Professor of Pharmacy Care Systems. But there are many other sources which seem to agree:

‘Communication that is persuasive is directed toward changing or altering another person’s beliefs, attitudes, and, ultimately, behaviours. Generally speaking, attitudes are composed of three components:
1. Cognitive…the manner in which the attitude object is perceived,
2. Affective…feelings of like or dislike toward the object, and
3. Behavioural…action tendencies toward the attitude object.1 The cognitive component is the person’s belief about the attitude object. The idea is that beliefs affect attitudes, which affect behaviours. Change a person’s beliefs or attitudes, and you change their behaviours. However, while there are relationships between beliefs, attitudes and behaviours, these relationships are not always straightforward.’

So we have three factors that need to be addressed:
1. Beliefs
2. Attitudes
3. Behaviour

The above comment above about the relationship between these three not being ’straightforward’ is indeed true. If someone believes that they are person of no worth, of no value, it’s not hard to see how this might lead to all sorts of ways of behaving which is damaging for the person. Putting a question mark over this belief is a good idea. Creating an opportunity for the person to experience themselves as worthwhile is certainly a very good idea. However, challenging a person’s belief for instance that children should do as their parents suggest, or that there is without question a creator, or that people are free to choose their own destinies, is likely to lead to a person simply resisting. Certainly not listening to what is being offered. In various forms of therapy (including narrative, solution-focussed and motivational interviewing to name a few), attempts are often not made to change beliefs, but to work with them and to find ways for them to be expressed in behavioural terms more constructively, compassionately. Banging up against people’s beliefs often just results in them pushing back.

‘Scare tactics’ have been used in the past and they have always been controversial. But it seems there can have impact depending on a number of ingredients. Here is some research about ’scary messages’. They work when (and I am inclined to agree)…
(1) the message provides a strong argument that the recipient will suffer a negative consequence if the recommendations are not accepted; and (2) the message provides strong assurance that adoption of the recommendations will eliminate the negative consequences.

So a little more simply, if we are going to try to scare or unsettle people we need to satisfy two criteria. A person needs to get the messages that:
1. If I keep doing this…it’s going to be awful!
2. If I stop…things will improve

And thirdly, it seems to help if we have:
1. The absence of coercion
2. The presence of compassion and concern

Okay, so with that as the background, let’s start to look at campaigns and ads that aim to help people be happier and healthier. There are a number of scenarios to this. Here are four:

1. How do we get people to do stuff that they believe is good for them and that they want to do? For example, exercise.

4. Okay now how do we get someone to STOP doing something that they believe is good for them, (and ‘good’ might mean, ‘it makes me happy, popular and it’s fun’), that they basically find attractive, and that they want to continue doing? Now this one is getting real tough. But I suspect a large number of the 168,000 young people in Australia who binge drink regularly fall into this group.

Let’s look at each of the above.

And the example I started with is, exercise. So imagine that we are designing an advertising program aimed at encouraging people to do more physical stuff.

To start with, communication theory would tell us that:
a. We say clearly to the person what we want them to do. Not what we DON’T want them to do
b. We give the person an action. And it needs to be something a person is able to do and is likely to do

So we say: ‘Walk 3 or 4 times a week for 40 minutes’. Okay, this all makes sense.

Importantly, the ad, as per ideas about persuasive communication, ideally also needs to :
a. Fit with what most of us believe
b. Fit with what most of us want to do
c. AND, give us clearly an action to follow through with

For example…

These ads have the element of humour. Always powerful.

This is a tougher job. But all of the above applies here too.

Littering isn’t good for the look of our towns and it’s bad for public health. Most people agree. Yet many people litter. Why do people litter? Or what stops people from putting their rubbish in bins or taking it away? Well many reasons for sure, so maybe the ads in the 80’s were aimed at the swinging voters who would do ther right thing if they were able to, or simply more mindful of what they are doing. So the ads say ‘Do the right thing.’ So the communication tells us to DO something rather than NOT do something. Here is a very dated corny ad from 1983 which shows just this.

So:
a. We agree that its a good idea to do…X
b. We (mostly) want to do the right thing
c. We are told just what to do…’The right thing’, put litter in a bin. (In fact in this ad we are actually shown numerous times what to do)

Again, the ad fits with what (most of us) believe, that is, that it’s good to have a clean community, and so we agree that littering is a bad idea, and we agree that we should do something about it and we may well take on board the suggestion as to what to do…put litter in a bin, an action which most people can take up quite easily.

I am not suggesting that ads like this turn us all into model citizens but they at least hang together in terms of what makes sense in encouraging us to act better for ourselves and for others.

Okay let’s look at how we encourage people to STOP doing something. This gets a bit tricky but smoking cigarettes is a good example. The latest ads encourage people to STOP doing something that they know is bad for them and do something that many people who smoke would like to do, which is quit. Okay so we have a fit with the belief but the action is harder. People would LIKE to stop, it’s just hard to do. But again people are given an action…ring this number!

So here too there is a fit with the belief and an action to follow it.

In the past we decided that scare tactics didn’t work. But we have refined our thinking about this somewhat. If we are not careful we can generate interest where there was none before (with say ads about ICE) but we can also show black horrible lungs, a scary unsettling image and yet hope for a quite different impact. The ad says to someone who smokes:
a. Every cigarette is doing you harm. ( This is scary)
b. You can stop. (This gives hope)
c. Here’s what you do: ring this number (This offers an action a person can do right now)

And this fits with the criteria for a usefully scary ad:
1. If I keep doing this…it’s going to be awful!
2. If I stop..things will improve

Let’s look at another ad specifically targeting adults and in particular, parents.

This ad encourages parents to think about their alcohol consumption and follows the same reasoning. Most of us care about our kids, and being encouraged to think about our drinking and the impact on our kids is a thing most of us would agree is also a good thing. We aren’t told in the ad exactly what action to take, but we are perhaps encouraged to rethink what we do around our kids. So the belief fits for us, and the possible action, a rethink or a mindfulness gives us something to do that fits the belief.

Cognitive dissonance theory states that a feeling of dissonance or distress occurs in people when they do or say something that runs in direct opposition to their beliefs or self-concept. The following ad seems to fit here. Not many parents really want to hurt their children. Yes, some also really do. But this ad is directed at ‘ordinary’ parents who might get it wrong from time to time. And in this case. tragically wrong. It’s a tough ad.

Now this one is getting real tough. But I suspect a large number of the 168,000 young people in Australia who binge drink regularly fall into this group. So we are talking about young people doing something which they think is fine and that they want to continue doing. How do we encourage them to stop? And this is where the anti-binge drinking ads come in. Here is the one aimed at under 18 year olds:

I am aware that that not all ads are aimed at all people, that each have target different groups, and that this one is designed to encourage younger teenagers to look after themselves. I agree with the intention but have some doubts about its effectiveness.

A lot of what is shown is actually attractive to young people. Drinking in parks is not something that I think is fabulous but this is irrelevant. Many quite ordinary otherwise ‘good’ kids do this regularly. So much of what we see in the lead up to the ‘disaster’ is seen as good. No matter what I might think, lots of young people like the idea of getting drunk and do so as quickly as possible. Some of the disasters; the running over by a car, are horrible…but hey…stuff happens doesn’t it? The possibly unwanted sex is not wonderfully attractive…but then again…and it matters not what I think…is this really that unattractive and unwanted…?

The following ad is aimed at over 18 year olds:

The dilemma for each of these ads is that they are in competition with the attraction of getting drunk. And the many many kids who are getting drunk are not for the most part ‘troubled’ kids (to use a bit of shorthand here). They are ordinary kids trying to have a good time. And the dilemma is that while NOT falling over and NOT being hit by a car are reasonably desirable, they are seen as simply part of the way things are, and the attraction of getting drunk I suspect is a much stronger pull than the fear of a possible disaster.

The crash into a table…yes…horrible…but…stuff again…happens doesn’t it? The ‘disaster’ of the fight in the bar is, I would suggest, not seen by many young men as a disaster at all.
Lots of young men don’t think fighting is especially okay but will certainly push back if pushed. And ’stepping up’ like this is seen as a good thing by many young men. So we have a double banger here where both getting drunk, and defending yourself (fighting) are seen as good things. The ad suggests that getting drunk and/or fighting are undesirable and this is simply out of step with what a lot of young people think.

So with these ads what we have is:
a. The message does NOT fit with an existing belief. It clashes
b. The message of what to do does NOT fit with what people want to do
c. The message is DON’T do something rather than DO something and this does not fit with communication principles
d. There is no possible action suggested (whether it fits with belief systems or not)

Elsewhere I have posted the following comments from Professor Christine Griffin of the UK. I will repeat them here. She says that:

‘Adverts that show drunken incidents, such as being thrown out of a nightclub, being carried home or passing out in a doorway, are often seen by young people as being a typical story of a ‘fun’ night out, rather than as a cautionary tale.’

And:

‘Not only does being in a friendship group legitimise being very drunk – being the subject of an extreme drinking story can raise esteem within the group.’

The ads below from the UK seem somewhat different and I have put them here by way of contrast. Take a look at these first two.

While these ads do not fit snugly with the principle of communication: That is, to say clearly what you want rather than what you don’t want, and they do have the dilemma of competing with the attraction of getting drunk, they also still have things that seem to be useful. They do meet the criteria of an unsettling message:
a. Most people believe if they continue to do this there may well be a disaster
b. Most people believe if they stop doing this, life will be better

The ads are aimed at teenagers and don’t show the attractive stuff about drinking…the actual getting drunk, and the fighting…they show the possible results of drinking that in themselves, many young people may well not want. And while not exactly humorous, they are kind of interesting. A bonus.

The ad that follows also does not fit well with communicating principles in that it does not directly say WHAT to do, but it does fit with what many young people believe. It shows what is likely to be a genuinely unwanted outcome of drinking. In this case, not only unwanted sex but what looks like gang rape. And as something unwanted this does fit with what many young people, female and male, think is a horrible thing.

This last ad below is aimed squarely at parents and fits reasonably well many of the criteria discussed above. The message is a DON’T message and this is perhaps not ideal and finishes by showing an image of what to NOT do…perhaps the ad serves as a reminder for parents who love their kids. that is, most parents, and encourages us to…’think about it…do the right thing.’

None of this is simple. And everyone is trying to get it right. And when we get it wrong, change it and get it right. Let’s keep on trying, experimenting and evaluating…and doing more of what may just help keep our kids well and happy.

I really thought that GFC meant ‘Go find carrots’. Yet while I was seeking vegetables I discovered my error, and that in fact GFC makes reference to our globe, to finance and to, apparently, a crisis. So I got in touch with a financial advisor I know and asked if I should be worried or doing something, because I was just about to have a coffee. He sent me this reply:

‘Pete
Have a double shot!!!
Nothing you can do except to sit tight and watch your super go back up
and interest rates drop!!!!
Regards’

And I was relieved because I really was about to buy a diamond mine in South Africa.

On the front page of this morning’s paper I read a description of the GFC (see how fast I learn!) that said:

‘This is the calm before the storm.’ And: ‘The point is that the bad stuff hasn’t really started happening yet.’

I am really interested in these views because:
1. I am intrigued that we still have people who are regarded as financial experts when it seems to be the very same people who were experts before the GFC and unable to do anything to avoid it. Handy having experts who can do nothing.
2. While noticing that we do indeed seem to have a problem, some (reasonably realistic) views and expressions of hope, optimism and positivism (is that a word?) seem much more useful and certainly much more welcome.

So I think I will attend to the advice that says: ‘Sit tight and watch your super go back up
and interest rates drop!!!!’

And while I am sitting around..and possibly having a coffee, here is a video that I found heart-breakingly beautiful and uplifting. I know I am a big sook but I think it might just be lovely anyway. I hope yous enjoy it too.

Our federal government seems to be concerned about young people binge-drinking. And this is good. Yet how we proceed needs some careful thought. Take a look at the following recent research from the UK. Professor Christine Griffin from the University of Bath, who led the research with colleagues from Royal Holloway, University of London and the University of Birmingham has this to say:

‘Extreme inebriation is often seen as a source of personal esteem and social affirmation amongst young people…’

She goes on to say that:

‘Adverts that show drunken incidents, such as being thrown out of a nightclub, being carried home or passing out in a doorway, are often seen by young people as being a typical story of a ‘fun’ night out, rather than as a cautionary tale.’

And:

‘Not only does being in a friendship group legitimise being very drunk – being the subject of an extreme drinking story can raise esteem within the group.’

I think something important is being said here. Behaviour perceived as a problem by adults or the wider society is not necessarily seen that way by the young people involved in it. And so how we tackle it needs some serious thinking.

The following ad, on the other hand, shows I think, a well-thought-out response. It reminds those of us who drink…er…and we are in considerable numbers…to be mindful of what we do, where we do it, and just and who is noticing. It seeks the best in us and reminds us to be the decent human beings that most people are most of the time.

This ad isn’t really directed at young people. But it’s not bad. Now we need to start getting it right with young people too.

In perspectives on our societies, there is always big picture stuff and small picture stuff, and getting the balance right in any approach to therapy (small picture) as well as our approach to legislation (big picture) seems important. As I sit in conversation with a person I am aware of just how intrinsic it is to the welfare of an individual to perceive themselves as being in charge of their life, (see, amongst others, the research of Len Syme, oft-quoted on this website) and to actually be in charge of their life.

I am also aware of the significance of the social determinants of health (see as much research as you wish including that of the World Health Organisation).

So in the big picture to hold individuals responsible when social conditions are appalling, just seems unjust. Similarly in the small picture stuff to see individuals as powerless to choose and take charge of their lives, seems not only unjust, but foolish and unproductive.

I have just come back from a week in Perth training Corrective Services Personnel (those working both with adults and young people). In broad strokes the training was about understanding what drives human behaviour, including the sometimes pretty ugly side of what humans are capable of, and looking at ways in which change can be promoted. This perspective is about face-to-face work with people, looking for the best in them and helping it emerge; helping a person be in charge of themselves and simultaneously respectful of those around them. It’s the small picture stuff…then of course on the other hand there is the big picture stuff; the social determinants of behaviour.

Speaking on Radio National’s ‘Perspective’ (29th September 2008) David Brown Emeritus Professor School of Law University of New South Wales, has this to say:

‘The highest imprisoning country is the leader of the ‘free world’, the US, with a rate per 100,000 population of 738, some 4 times that of New Zealand, 6 times that of Australia, 8 times that of Germany, 11 times that of Norway and 12 times that of Japan.’

He goes on to say:

‘Focussing only on advanced western style democracies, those countries with the highest ‘imprisonment rates are “neo-liberal” countries with liberal market economies: USA, South Africa, NZ, England/Wales and Australia. The next bracket with lower rates Lacey tags “conservative corporatist” with “co-ordinated market economies” such as The Netherlands, Germany France, and Italy. With lower rates still come the “social democracies” with “co-ordinated market economies” such as Sweden, Norway, Finland and Denmark, followed by “Oriental corporatist with a “co-ordinated market economy” such as Japan.’

And:

‘The relatively disorganised, individualistic liberal market economies are particularly vulnerable to penal populism, for ‘liberal market systems are oriented to flexibility and mobility and turn to punishment as a means of managing an excluded population’.

And in this final comment there might be some coming together of the big and small picture perspectives:

‘By comparison ‘co-ordinated systems which favour long term relationships -through investment in education and training, generous welfare benefits, long term employment relationships -have been able to resist the powerfully excluding and stigmatising aspects of punishment.’

David Engwicht is maybe one crazy fella. Now is that bad? I must read more of what he says but one of his books is called ‘Mental Speed Humps’…and (if I’ve got this right) he is saying that the more traffic rules we have the less we seem to take responsiblity for what we are doing. We kind of trust in ‘THE RULES’. And there seems to be increasing evidence across Europe that when the traffic rules get taken away, accidents reduce. Yes..reduce. Because we start to pay more attention, be more aware, be more sensitive and more alert and more mindful of others. Kind of makes sense really.

I facilitate many groups and have long been an advocate for working in groups without rules – though I hasten to say that discussions about how we want to work together is something else -because everyone knows what respectful is, and a rule that says we must be respectful is kind of paradoxical. So the ‘mental speed bumps’ idea certainly makes sense to me in terms of running groups. And it makes sense in terms of helping organizations run well. People tend to know already what is fair and what isn’t. If you are in a relationship, you may not have the rules written up on the wall but you sure as heck know whether it’s okay to go out to a bar tonight and pick up someone you might just fancy. We do have ‘mental speed bumps’ and they are good for us.

I suspect David is ever so slightly provocative, as he sits here in New York city in his chair…making a statement about reclaiming the streets…

Nothing wrong with that really.

This is a bit of a development from the last thing I put up. The camp where most of us were young-ish…and some of us somewhat older. And good things happened:

And as our 5 day camp together came to a close I asked a question of a bunch of people of various ages ranging across 35 years. This is what I asked: What is the best thing in the world? And this is what they said:
Life
Music
Friends
Children
Life
Music
People
Life
Love
My daughters

So…how would you answer the question? What do you think is the best thing in the world?

This is the stuff that always worries me. The article in a widely read daily newspaper is called ‘Heaven and Hell’ and is about ‘Ice’, the crystalline form of methamphetamine. And I will assume the best of the journalist, that they were trying, in the course of doing what journalists do – which is to write articles – to be responsible in alerting us to the dangers of something in our society.

Yet I worry. One person talking of their use of ice said: ‘…you were instantly much, much higher. It’s hard to describe.’

The article goes on to say that a couple who had used found ‘…there was no hangover, no crash, no anxious-depressive speed comedown. It was the best of all worlds.’

The article also has a section which looked at the downside and this was called ‘The chilling facts.’
Chronic depression
Agitation
Severe paranoia
Proneness to acts of violence
The acceleration of apoptosis, or natural cell death…which…can result in…premature ageing.

So are we scaring people here, or just making them thoughtful? Would someone reading this reconsider using this or other drugs? What stands out for people as they read? Do we say to ourselves, as most of us do who get into cars, that (with considerable evidence to support our belief by the way) we will make it home safely?

I continue to worry about WARNINGS. Yes, we need to know what could await us if we do…X. And yes, we really do need information…and yet still people enter into relationships knowing that there is something like a 40% chance of that relationship ending up on the rocks. We continue in the hope that we will be happy, that our hearts will not be broken. That tragedy will befall us. That we are in the other group, the 60% who are make it. Or we tell ourselves that the risk is worth it.

Here is a footballer…with just a little damage…..

Concussion
Chipped tooth
Separation of joint in shoulder
Cracked ribs
Torn pectoral muscle
Externally rotated hip
Abdominal hernia
Shattered bone in finger
Snapped bone in finger
Cracked thumb
Bruised femur and tibia
Torn ligament
Hamstring sprains
Sprains
Bone erosion in ankle
Bone spurs in ankle

If we told him when he was younger that this would happen to him would he have continued? Well what do you think? I suppose we could point out this example to young players and they would ….do what? Stop playing? Or would they say to themselves…’it won’t happen to me.’ Or will they say: ‘It might happen…but it’s worth it!’

We really do need to be thoughtful about what we think might be useful.

I bet you thought you knew what was important? And you’d be right. Body hair! This newspaper article tells us so. Whether guy or doll, bloke or sheila, male or female, excess body hair is something you do not want.

And you can wax, or you can IPL (this is not canned fruit ha! ha! ha!); it is as you know, ‘intense pulsed light’. This starts at around $70 and a full body job is about $300. A bargain. Then there is threading which is of course rolling a cotton thread over what the article describes as ‘rebellious brows’ and a bunch of hairs is then ripped out. And we have of course the more familiar depilatory creams which seem at least to be painless. Sometimes there are just too many things to get excited about aren’t there.

And what’s just fabulous about this of course is that it used to be only women who were worried about such things. But with equal opportunity exploitation men can now line up for a new piece of superficiality to be concerned about. Oh lucky lucky.

So I’m listening to dear old radio national (The show is ‘Life Matters’ May 19th 2008) and I hear Martin Seligman and others talking about teaching Happiness (I added the capital H. It was radio after all) at a fairly flash school in Victoria. And the discussion scrolled through whether it was a good idea, whether most schools could afford the millions Geelong Grammar is spending on this, (the answer is ‘no’), whether there were down-sides, the place of parents in the whole process…a lota stuff. And Michael Carr-Gregg (well know psychologist) was saying that he was seeing kids with ’spiritual anorexia’ and who were filling the void with ‘rampant aflluenza’ and adoration of silly popular figures. (Cannot bear to repeat who was mentioned)….

And, possibly the week before all this I was reading Ruth Ritchie in The Sun Herald on 7-8 June who was saying: ‘We live in a time when contests are not won but lost. The focus is not on the winner but on the fear and humiliation that surrounds loss, abandonment, betrayal and eviction.’

She was of course, talking about the many and various ‘reality’ TV shows where ‘…the winners are so rarely qualified or to be admired for being anything other than the last limpets hanging on to the rock in a tsunami.’

And I think she has a point. She described these processes of elimination as ‘…heartily endorsed, institutionalized bullying.’ And this is all kind of sad really. It seems that depending on the show, people have the chance to be yelled at by a chef, sacked by a rich guy or snarled at by ‘upper class ladies.’ I’m sure there are more shows but gee it’s hard to keep up. So given that we have this awful stuff going on, and let me not make too light of it, I do think it’s awful, maybe the idea of teaching happiness is not a bad idea after all.

And it seems (back to the radio show) that those who are happy tend to be more altruistic, so the idea isn’t about being selfish. They seem to volunteer more, do more stuff for others. So the happiness idea seems to be about being personally strong, about being connected and about doing something meaningful in life. And so yes, all ideas can be turned into something silly (we’re good at that aren’t we for some reason?) or turned into something which exists in name only and is devoid of its own intended meaning. But maybe doing something which isn’t a silly TV show (especially one based on being mean to others), but something which encourages us to be decent to others and ourselves…maybe that ain’t so stupid.

This is just so lovely that I had to add it. Ta Sam for sending it to me. I have read comments that the music is boring…I find it moving, inspiring and delightful. Somone also said that a younger person should have mixed it…though ya know being older maybe aint so bad…and interesting to see Missy Higgins and John Butler in the clip…they aint so old are they? And anyways of course…we all just have opinions. I like this vid.

http://www.youtube.com/watch?v=x7QV5cEDfYY