How can we deal with COVID-19 denial?

Or any denial of reality?

This newsletter focuses on COVID-19 denial, but the ideas apply to any denial of reality. If you’re dealing with someone who doesn’t seem to understand, try this technique.

Here’s a tweet thread from a person who works in a hospital (@JodiOrth), which illustrates COVID-19 denial:

“I have a night off from the hospital. As I’m on my couch with my dog I can’t help but think of the COVID-19 patients the last few days. The ones that stick out are those who still don’t believe the virus is real. The ones who scream at you for a magic medicine and that Joe Biden is going to ruin the USA. All while gasping for breath on 100% Vapotherm. They tell you there must be another reason they are sick. They call you names and ask why you have to wear all that “stuff” because they don’t have COVID-19 because it’s not real. Yes. This really happens. And I can’t stop thinking about it. These people really think this isn’t going to happen to them. And then they stop yelling at you when they get intubated. It’s like a fucking horror movie that never ends. There’s no credits that roll. You just go back and do it all over again.”

Then someone responded in another tweet with a quote from Dietrich Bonhoeffer that says, “Stupidity is a more dangerous enemy of the good than malice. Against stupidity, we are defenseless. Neither protests nor the use of force accomplish anything here; reasons fall on deaf ears; facts that contradict one’s prejudgment simply need not be believed — in such moments the stupid person becomes even more critical — and when the facts are irrefutable, they are just pushed aside as incidental. In all this, the stupid person … being easily irritated becomes dangerous by going on the attack.”

We see this same phenomenon in lots of parts of our lives: climate change denial, COVID-19 denial, refusal to accept the election results. Some of this was true before Donald Trump was elected, but he has amplified and twisted this trend. His sniping at Dr. Anthony Fauci, his repeated statements that we’re rounding the corner, and the way he’s egged on people who are rebelling against local governments has turned the pandemic into a political issue. But many issues have become issues on a political agenda and that means your position on an issue is a signal of what “team” you belong to.

It’s easy and common to dismiss people who follow what the president or particular media say as stupid. But it is actually dangerous to scorn them like this because then you’re giving up and accepting that you can’t do anything.

The point of this newsletter is help you figure out how mend relationships. This applies to relationships between hospital staff and patients and also between relatives who are concerned about their loved ones’ behavior. Or those who really believe in an issue and want to do something about it without being heavy-handed in a relationship. So, what can we do?

First, we need to understand that the people we’re talking to are not literally stupid. Let me repeat that: Psychology research has studied people like this and concluded that they aren’t stupid. They actually have a different issue; they tend to come conclusions quickly. Their coping mechanism is to outsource their hard thinking to a trusted authority.

This can work well in some cases. But in these cases, it may not be working very well. Certain politicians and media sources are feeding the denial, and even when it conflicts with what the person sees, they still cling to what their particular trusted source has said.

Second, as I implied before, the issues have become associated with a position that a certain political party or other group has identified. To be consistent with the nature of belonging to that group, this person has fallen into line in support of that issue, again without giving it extensive thought. 

How can we counteract the effect of belonging and trusting an authority who might not be trustworthy? How can we deal with this in a productive way and not just reject any hope of relationship or treatment?

I’m going to suggest an adaptation of a technique called the illusion of explanatory depth. Studies have shown that when we can get people to slow down their thinking, to really take an inventory of what they know and they don’t know, they tend to realize that they don’t know a lot. This is exactly the opposite of what their tendency is, so it isn’t easy for them to do — but it does work. They’ve done studies on this where the topics are as varied as how zippers work, how toilets work and, most recently, how economics works. In all these cases, people who are asked to explain in-depth what they know about a topic when they aren’t an expert, are later more open to hearing from an expert. It gets them to slow down their responses and think for themselves.

How can this work in this situation? The first step is to ask questions. Or if that’s too much (and it might be too much as in the overcrowded hospital situation described above), give them a tablet and ask them to write it down. Then, you can tell them you’ll review it and come back with answers to any questions they have. You can load it with an explanation of what you want them to do and also some probing questions such as:

·       What do you know about (fill in the blank)?

·       Where did you learn the information that you do know? What other sources have you checked?

·       How do you know to trust that source? How does that source get their information? What things have they said that have worked out? Are there any times when what they said hasn’t been true?

·       How has this affected your life? Have you had to make any sacrifices?

·       Are there sources you don’t believe? What are they? What do they say? Where do they get their information from? How do you know that what they say is a lie?

Specific to COVID-19:

·       Do you know any doctors or nurses? What do they say?

·       Do you know anyone who was sick? What happened to them?

·       What questions do you have for the staff?

You get the idea. By the end of this, they will have taken an inventory of what they really do know and what they don’t know, and hopefully, they’ll be more open to hearing what you have to say.

Then, pay attention to their concerns and agree with what you can. For example, you might say something like, “I agree that it’s been confusing how quickly the information has been changing as we discover new things about this virus. I’ve had to work really hard to keep up-to-date with the new information as it changes.” Or “Yes, you’re right, maybe they didn’t need to close down the stores in this area early in the pandemic.” Or even just simply, “It’s scary what is happening now.”

After you agree with something they’ve said, then you can add something that reflects what you know that addresses their concern. Perhaps it is the number of people who are on ventilators in your hospital or your area. It can also be more powerful if you use one of the moral foundations in your statement. If they’re conservative, use something from the sacredness/purity moral foundation (If you don’t know about moral foundations click here to learn more, or read my book, Persuade, Don’t Preach, for even more detail), such as, “This is nasty, disgusting disease.” You could also throw in something from the belonging moral foundation: “But we Americans can beat this disease.” And, for Trump supporters, you might want to remind them that the president did have to be hospitalized and he had the latest treatments, so they might want to consider doing the same thing.

I hope this technique helps you make some headway when talking to people who are denying reality in some way — especially those of you on the front lines. In the next few weeks, I’ll be addressing vaccine hesitancy and how public health workers can use these same techniques on that issue. Subscribe to this newsletter so you don’t miss it and consider passing it one to anyone it could help.