I have a friend whose marriage is failing due to a misinformation addiction. She and her husband have always had differing political views, but their yin and yang were endearing intellectual fodder for respectful and playful debate. But things have changed dramatically in this new world we live in.
“If it was alcohol or drugs, I could hold on and we could figure it out together,” she told me. But what do you do when your spouse is addicted to obscure news sources and communities swirling around them?
Noel Brewer, PhD, professor of public health at the University of North Carolina at Chapel Hill, specializes in studying why some people refuse or oppose vaccinations. Even after two decades of research on this subject, today’s environment shocks him. “Some people,” he told me, “have turned their love affair with misinformation into a defining personality trait. It’s finally their chance to take a walk on the wild side.
Prone to anxiety and depressive symptoms, my friend Hank’s (pseudonymous) husband has been hit hard by the pandemic. He’s a stay-at-home dad with young kids, and he’s had a lot to deal with during COVID shutdowns and distance learning with limited social outlets. A gaping void was left by the loss of normal school, sports and play dates, and Hank’s community began to revolve around social media and online committees. It started with a group of wellness-focused parents who kind of turned to QAnon.
Hank has become a vocal anti-mask at school board meetings. Soon he was criticizing vaccines on social media and at the dinner table. A bitter row ensued when two of the couple’s children became eligible for the COVID-19 vaccine; they were ultimately not vaccinated. Then he fell ill. Her symptoms progressed for two weeks, first fever, then cough and chest pain. Then comes bed-ridden dizziness, which coincides with the delivery by post of a medicine from India. My friend found the box; it was labeled “Covermectin”.
All the while, Hank refused to get tested, not even before starting doses of ivermectin better suited to a large farm animal, not even before taking the kids to visit his parents, who were also skeptical of the vaccine. , not even after his mother fell ill.
Dr. Brewer was selected for in-depth study of two health-related behaviors that seemed to require complex decision-making, vaccination and disease screening, when he began his career at UNC. He has since discovered that vaccination is driven by many environmental factors and is in fact often “not a decision in the ordinary sense of the term”. History, culture and fear play a role in the likelihood that a community will accept a vaccine. What seems to be new these days, he said, is the extent to which misinformation about vaccines has become a sectarian obsession.
Misinformation, addiction, and cults all have one thing in common: a person’s “vulnerabilities” can make them more susceptible to falling prey to the lure. Those with a history of anxiety or depression are at higher risk of developing addiction and joining cults. Experts call the first stage of sectarian involvement narcissistic seduction. (A Fournier, Monroy M. [1999.] Sectarian drift [translation: Sectarian Drift]. Paris: Presses Universitaires de France.)
The ego and its vulnerabilities are exploited through flattery and groupthink. Many new cult members seek refuge from addictions to other things or family dynamics and find that their new cult environment, at least initially, provides psychological relief. This honeymoon period can last for days, months or years. (J Nerv Lie Dis. 1978;166:685.)
The cult recruit is removed from his previous life during this time. Researchers found in a study of 31 former cult members that the repercussions of cult membership affected all areas of life – social, family, marital, professional and financial. (Res Psychiatry. 2017;257:27; https://bit.ly/3uE8dQq.) The study also described the type of people attracted to the narcissistic seduction of cults, and they look a lot like Hank. Most of the cult victims in the study were well-educated and had long-time partners and a history of anxiety. The ramifications of being caught up in a cult reminded me of what happened with Hank. Over 50% of cult members reported reduced social life and 45% were isolated from family and spouse.
Our era of COVID uncertainty and isolation just doesn’t seem to be going away. Rates of anxiety, depression and substance use have skyrocketed. It’s no surprise that the cult mentality can serve as a psychological safety blanket for many, like Hank. He has a community of like-minded people cheering him on as he fights with his family and community about masks, vaccines and the very existence of COVID. Even his own mother’s illness did not influence Hank; when he learned she was sick, he drove for half a day to deliver Covermectin. Despite sieges in the 80s, Hank’s mother refused to go to the hospital, and Hank and his siblings did not insist. They stayed in place to lend their support. Support without a mask.
My friend didn’t know what to do. Unlike a substance use disorder, there was no intervention or program available to rely on, no 12 steps or anonymous misinformation. It is strange how little guidance is available on how to deal with this scourge despite centuries upon centuries of misinformation of various incarnations (state propaganda, false prophets and manipulative advertising à la Mad Men) and despite the fact that being duped is an almost universal practice. human experience.
How can we help Hank and his family? If we view his situation as an addiction – an addiction to misinformation – we have to ask ourselves: can it be treated? How? ‘Or’ What? Spoiler alert: the cure won’t be easy. But consider several options borrowed from programs designed to address other addictions:
A different obsession
The idea is to share scary information to change behavior. Every parent knows this technique: “If you put your hand in the cage, the Gila monster will bite your finger.” The communication of fear could be about what Hank has to lose: his marriage, his children, his family’s health. The problem is, as we know, fear often fades quickly. Even if such communication triggers awareness, it does not mean that it will translate into action. Unfortunately, as with other addictions and behaviors such as substance use and driving after drinking, fear communication has been shown not to produce lasting change. Returning to COVID, Dr. Brewer noted, “Fear communication does not increase vaccine uptake”, and is “unlikely to do better in breaking people’s addiction to misinformation”.
Just as a recovering alcoholic becomes addicted to fitness, perhaps one obsession can be traded for another. “It may be unrealistic to treat misinformation addiction in the usual sense,” Dr. Brewer said. “Instead, we could encourage people to turn their attention to a new little addiction, like baking bread, fantasy football, or Pokémon Go.” Unfortunately for Hank, his other obsessions were fitness, natural foods, and mindfulness, and these were his gateway to misinformation. Fantasy football and Pokémon Go probably won’t change that.
One of the ways out of addiction is to hit rock bottom. The weekend that ends with the purchase of a monster Gila followed by the totaled Chevy in a ditch can be a transformative moment that purges the demons, if it doesn’t land the addict in the hospital or worse. At best, it’s an organic moment, emphasizing the risks and motivating the addict to move on.
crisis of faith
The most common reason people leave a cult (the average cult member spends almost nine years under the spell) is because they lose faith in the beliefs of the group. The provocation of this crisis of faith is often a family or social intervention.
That’s where my friend was, planning an intervention. A rather simple job, in fact, a part-time job, something that could get Hank out of the house and expose him to real face-to-face social interaction. The job, she thought, could lift Hank out of the vacuum of exponential misinformation. She was making headway with this idea when Hank’s crisis hit. Her brother, who had also rushed to help their mother when she was sick with COVID (unsaid), fell ill. Unvaccinated and in denial, the brother went to bed early one night. He was found dead the next morning.
EPs see drug addicts all the time. There is no single answer to help them. They have taken many paths to become addicts, and a path out is never the same as someone else’s. But the roadmaps worked for others, at least for drugs and alcohol. I believe misinformation is addictive, and Hank and indeed our nation needs lifelines. The sooner we admit there is a new (rather) dangerous addictive substance, engaging the same neurotransmitters that fuel substance use, gambling, and cult membership, the sooner we call it addiction misinformation, the sooner we can help Hank and countless others whose lives and families are being destroyed by an insidious, faceless threat.
Still, last I heard, Hank had yet to acknowledge or release his addiction, but he had agreed to apply for a job. This may be step 1 of his 12 steps to breaking free from misinformation.
Dr Ballardis an emergency physician in San Rafael Kaiser, past president of KP CREST Network, and medical director of Marin County Emergency Medical Services. add after Services. Follow him on Twitter@dballard30. Read his past articles onhttp://bit.ly/EMN-MedClear.