(by Kevin Simler, Robin Hanson)
Why do patients spend so much on medical care? To get healthier: That's their one and only goal, right? Maybe not. Consider data points:
Altogether, these puzzles cast considerable doubt on the simple idea that medicine is strictly about health.
People might have other motives for buying medicine (beyond getting healthy) and that these motives are largely unconscious. Medicine isn't just about health--it's also an exercise in conspicuous caring.
We're suggesting that key human behaviors are often driven by multiple motives; secondly, we're suggesting that some of these motives are unconscious; and these are elephant-sized motives large enough to leave footprints in national economic data.
Inspired by Hierarchy in the Forest (Christopher Boehm): parallels between chimpanzee societies and startup/business societies.
People don't typically think or talk in terms of maximizing social status or showing conspicuous care. And yet we all instinctively act this way. In fact, we're able to act quite skillfully and strategically, pursuing our self-interest without explicitly acknowledging it, even to ourselves.
We, human beings, are a species that's not only capable of acting on hidden motives--we're designed to do it. Our brains are built to act in our self-interest while at the same time trying hard not to appear selfish in front of other people. And in order to throw them off the trail, our brains often keep "us", our conscious minds, in the dark. The less we know of our own ugly motives, the easier it is to hide them from others.
Self-deception is therefore strategic, a ploy our brains use to look good while behaving badly. As long as we continue to tiptoe around it, we'll be unable to think clearly about human behavior.
Box 1: "The Elephant"
The elephant in the brain, in a word, is selfishness--the selfish parts of our psyches. But it's also broader than that. Selfishness is just the heart, if you will, and an elephant has many other parts, all interconnected. "The elephant", therefore, refers not just to human selfishness, but to a whole cluster of related concepts: competitiveness fighting for power, status, and sex; our willingness to lie and cheat to get ahead; that we hide some of our motives and that we do so to mislead others.
At least four strands of research all lead to the same conclusion: that we are "strangers to ourselves":
Microsociology. The depth and complexity of our social behaviors (laughing, blushing, tears, eye contact, body language)--our brains choreograph these interactions on our behalf, and with surprising skill.
Cognitive and social psychology. Our brains aren't just hapless and quirky--they're devious. "At every stage [of processing information]--from its biased arrival, to its biased encoding, to organizing it around false logic, to misremembering and then misrepresenting it to others--the mind continually acts to distort information flow in favor of the usual goal of appearing better than one really is." The introspection illusion, the fact that we don't know our own minds nearly as well as we pretend to.
Primatology. Humans are primates, specifically apes. When we study primate groups, we notice a lot of Machiavellian behavior; when asked to describe our own behavior, we mostly portray our motives as cooperative and prosocial.
Economic puzzles. When we study specific social institutions--medicine, education, etc--we notice they frequently fall short of their stated goals. In many cases, this is due to simple execution failures. But in other cases, the institutions behave as though they were designed to achieve other, unacknowledged goals.
We act on hidden motives together, in public, just as often as we do by ourselves, in private. And when enough of our hidden motives harmonize, we end up constructing stable, long-lived institutions that are designed, at least partially, to accommodate such motives.
Box 2: Our Thesis in Plain English
- People are judging us all the time. One of the important things they're judging is our motives.
- Because others are judging us, we're eager to look good. So we emphasize our pretty motives and downplay our ugly ones.
- This applies not just to our words, but also to our thoughts. Why can't we be honest with ourselves? The answer is that our thoughts aren't as private as we imagine; in many ways, conscious thought is a rehearsal of what we're ready to say to others.
- In some areas of life (politics), we're quick to point out when others' motives are more selfish than they claim, But in other areas (medicine), we prefer to believe that almost all of us have pretty motives.
Let's start at a simpler beginning: two animal behaviors that are hard to decipher. In each case, the animals appear to be doing something simple and straightforward, but as we dig beneath the surface, we'll find extra layers of complexity.
To keep their fur clean, primates enlist the aid of others to groom their backs, faces, and heads: social grooming.
At first blush, social grooming looks like an act of hygiene, a way to keep one's fur clean. But we can't take it at face value:
Most primates spend far more time grooming each other than necessary to keep fur clean. (Gelada baboons spend 17% of their daylight hours; other primates spend 0.1%, and birds 0.01%.)
Primates spend a lot more time grooming each other than they spend grooming themselves.
We can correlate the average body size with the amount of time they spend grooming--if grooming were strictly a hygienic activity, we'd expect larger species (with more fur) to spend more time grooming each other. But in fact there's no correlation.
Primatologist Robin Dunbar suggests social grooming isn't about hygiene--it's also about politics. By grooming each other, primates help forge alliances that help them in other situations. "Grooming creates a platform off which trust can be built." This explains why higher-ranked individuals receive more grooming than lower-ranked individuals. It also explains why grooming time across species is correlated with the size of the social group, but not the amount of fur.
The Arabian babbler (bird) lives in small groups of 3 to 20 members who collectively defend a small territory of trees, shrubs, and bushes that provide much-needed cover from predators. Babblers who live as part of a group do well; those who are kicked out of a group are in great danger. Male babblers arrange themselves into rigid dominance hierarchies. At first, these activities seem straightforwardly altruistic, but closer inspection suggests otherwise.
To find out why we misconstrue animal motives, including our own, we have to look more carefully at how our brains were designed and what problems they're intended to solve.
Last modified 31 December 2020