Trying to talk with people who are self-righteous, certain and profoundly wrong is a toxic conversational mix. In fact, such conversations just might make your head explode. Unfortunately, the current risk of exploding heads is high because anti-vaccine advocates have mobilized to spread dangerous fear-mongering messages. Their actions are in response to others mobilizing legislative efforts to prevent more outbreaks of preventable disease, like the recent measles outbreak traced to California's Disneyland. It’s quite a mess. Help is needed. So, read on for advice for how to prevent cranial detonation when talking with the anti-vaxers in your life.
To vaccinate or not to vaccinate, and who gets to decide, is the question. Should families be allowed not to vaccinate children for non-medical reasons of personal conviction? Should you? Or are the lives of the many—especially the elderly, children with medical conditions, and others with compromised immune systems—more important than the convictions of the few?
On April 22 the California Senate Education Committee advanced a bill to limit vaccine exemptions on the basis of personal belief, after an earlier debate that included the bill’s sponsor being threatened and compared to Hitler. The Vermont Senate, also on April 22, voted 18 to 11 to “end the philosophical exemption for childhood vaccinations and to make the full range of shots a condition for enrolling in school,” stated the Burlington Free Press.
Even network TV is getting involved. On the April 8 episode of Law and Order, SVU (spoiler alert) an anti-vaxer Mom, played by an actress who looks like Jenny McCarthy, the anti-vaccine advocate and now pitch-woman for smokeless nicotine delivery systems targeted at teens, was found guilty of reckless endangerment for lying about mandatory vaccine records.
On the other side are people like Robert F. Kennedy Jr., a professional anti-vaccine advocate who actually invoked the “h” word to describe life-saving vaccines. Here’s what he said in the Sacramento Bee: “They get the shot, that night they have a fever of a hundred and three, they go to sleep, and three months later their brain is gone,” Kennedy said. “This is a holocaust, what this is doing to our country.” A holocaust, really? He’s comparing the history of industrial strength genocide—millions and millions intentionally exterminated—with vaccinations shown by the best medical science to be safe and effective. If this isn’t enough to make an educated person’s head explode, nothing is.
Or consider the naked fear that recently poured from the radio. A young mother, interviewed about the California vaccine exemption law hearings, is paralyzed by the fear vaccines will harm her daughter: “"I am afraid that her big beautiful blue eyes will not focus on me anymore, and she won't be the kid that she is.” She came across as kind, sincere and loving, and not receptive in any way to any statements of evidence or reason. Fear management was all.
This polarized mess is unlikely to change any minds or have much of an influence on anyone’s decision-making. It’s an acidic tangle of fear versus fact, emotion versus evidence. It locks people into rigid points of view. Anti-vaccine advocates feel victimized. Reasonable people are reduced to sputtering, wordless anger when trying to respond to the various rationales offered for why healthy children should not be vaccinated against potentially life-threatening illnesses.
So, what to do? Is there some way to talk to people about deep-seated, extravagantly claimed beliefs that are dangerous to others and also unfounded, except in fear. The obvious possibility is trying to address the wrong-headed conclusion with reason and evidence. However, that does not work. Something I learned early in my clinical training is that when faced with a belief that is false, fixed, and remote from reality, evidence and reason no longer matters. You have to be subtle and come at those beliefs from the side. Here’s how I learned this lesson.
I was working for the first time on an adult inpatient psychiatric unit with psychotic adults. The patient I was to evaluate was extremely fearful. After some time he divulged that the source of his fear was the FBI agents in the unit's waiting room. They were after him, and had been so for weeks and weeks for reasons he could not say. In fact, the stress from their relentless pursuit is why he needed to be in the hospital. Being as inexperienced as they come I thought, “this will be an easy one.” I’ll just take him to the waiting room and show him that no agents were laying in wait; confronted with this irrefutable evidence his delusions would begin to crumble. Timing it for when I knew the waiting room would be empty, I escorted him through the unit’s locked door into a linoleum clad room with a dozen or so plastic chairs. All were empty. Mustering the most empathic, understanding voice possible I reassuringly said “See, you’re safe. There are no agents here.” He takes a moment, looks around and says, “OK, I get it.” And then he pauses, looks me in the eye and says, “You’re one of them. You’re in on it. Get me a new doctor!”
The depth of his irrationality was startling. I should have known better than be surprised by it. But I was young and naive. And this is similar to how I feel when citing evidence, or seeing someone else cite evidence, talking with anti-vaxers. But now I've had experience with the all too human reality that evidence and reason, even when clear and unambiguous, does little to reassure the fearful when they are certain they know the identity of their enemy.
So, what does one do when confronted with irrational certainty, like life saving vaccines being a holocaust or the FBI sending agents to the waiting room of a psychiatric inpatient unit? Rather than directly confronting false conclusions with data, a fool’s errand if there ever was one, I’d like to suggest a few aphorisms, some clearly ironic, that just might get the attention of the erroneously certain. Like the way dropping a few grains of sand into a smoothly running machine can sometimes cause the gears to stop spinning, sometimes a few truths can help undermine the well-oiled certainty of the confused. And even when these little grains have little or no effect, at the very least they can give the reasonable a way to avoid cranial detonation.
So, here are few grains of conversational sand that might be useful:
Organic Food Is The Real Cause Of Autism
J. Emory Parker carefully charted the prevalence of autism and sales of organic foods over time. Here is a graph of his results:
Clearly, this research establishes organic foods as the real culprit in the rise of autism. Or, sarcasm aside, Parker wonderfully illustrated the classic error in judgement taught in every research methods class: correlation does not imply causality. Unfortunately, this error is everywhere in the anti-vaccine movement. In fact, it is foundational for the anti-vaccine movement. So, the next time someone rants that vaccines cause autism because kids are getting more and more vaccines while more and more are being diagnosed with autism you may want to share this graph with them, and hope they do not take it literally lest they stop buying organic.
The Plural Of Anecdote Is Not Data
Painful stories about a child diagnosed with autism or some other “vaccine injury” are endemic. The heart really does break when hearing them. They are the backbone for Kennedy’s holocaust fear-mongering. But the emotional force of these stories does not provide data linking vaccines with bad outcomes, nor does the number of them or the frequency with which they are repeated establish that link. The data show, as clearly as any medical data can show, that there is no link between vaccines or vaccine ingredients and autism. The stories don’t change that. What anecdotes of so-called vaccine injuries show is our need to find solace in stories to explain unexplainable tragedy and pain. They give form to suffering. These stories are central to a well-lived meaningful life. But they are not data.
Both Vaccines And Airplanes Are Dangerously Unsafe
Anti-vaccine rhetoric is replete with comments about the perfidy of “Big Pharma.” But consider that over the years Boeing, the airplane manufacturer, has been cited for business practices that push well beyond the limits of lawfulness. But despite these practices the planes still fly as safely as ever. And I do not know of a single person who has boycotted air travel because of a manufacturer’s corporate greed. With vaccines it’s different. The business practices of “Big Pharma” are frequently cited as a reason not to trust any claims of vaccine safety and efficacy. But vaccines are safe and effective, just like planes are able to fly.
We Should Have More Guns And Less Vaccines In Schools
The foundation for a “personal exemption” from mandatory vaccination is protecting individual rights. “It’s not about vaccinations, it’s about personal choice” goes the cry. It is the same argument as the one made by gun advocates to give teachers open carry permits on the job. After all, a constitutionally protected personal right is a personal right. Educational experts decry this argument. Educators know this will make schools more dangerous. But gun advocates dismiss the experts. So too with medical experts being dismissed by anti-vaccine advocates trumpeting personal choice. The hope is that this comparison might give pause to the certainty of the anti-vaccine advocates. After all, when experts agree that personal choice will cause others to suffer and die then personal choice ceases to be a rhetorical trump card, whether we are talking about guns or vaccines.
Water Is Too Risky To Drink
One of the more maddening aspects of anti-vaccine rhetoric is a failure to understand that the ratio of risk to reward is what’s important. It’s the ratio, not the risk alone. For example, water has risks. It could be contaminated with something awful. Who knows? Plus, even if the water itself is safe you might swallow it wrong, perhaps even dangerously sucking some down into your lungs. Of course, the risk is so small and the rewards so great, like staying alive. Plus, everything has risk, including the risk of not drinking the water. So go ahead and pour yourself a nice big glass. Same thing with vaccines. There is risk. Nothing is 100% safe. But the risk is minimal compared to the rewards. The reward of not contracting smallpox is so high, as is not infecting your child’s classmate who has leukemia with measles, that vaccinations and ending personal exemptions is just the right thing to do.
SShhhhh! Don’t Tell Anyone Your Child Is Not Vaccinated
I’m not really suggesting lying, and possibly committing a crime. Rather, as a last ditch effort against your head exploding you may want to point out that the most rational vaccination strategy is to keep quiet about refusing vaccines. Let the anti-vaccine advocate know that their advocacy puts their child at increased risk. After all, the absolute safest child on the planet would be the sole unvaccinated individual in a world of vaccinated others. Let others shoulder the burden of minimal risk. Encourage the advocate to skim the cream off the top of our shared biology. Encourage them to be among the “immunological one-percenters” who benefit at others’ expense. And while this is factually true it will likely have little effect other than giving the speaker the satisfaction of being able to tell an anti-vaccine advocate to keep quiet about their fears that put others at risk.
Finally, if none of this works and you still feel like your head really is about to explode, repeated viewings of Penn and Teller’s widely popular short video can help:
For updates on “Managing Mental Wealth” and related news and links follow me on Twitter. To contact me click the mail icon above.
