Institute For The Future

Rediscover Wakefulness

 

One of the themes emerging from our Health Horizons research this year is that people are developing expanded meanings of health and well-being at the same time that we're on the verge of having a much broader set of tools to make those visions of health and well-being possible. As I noted a couple weeks ago, once health is expanded beyond the concept of not sick to something well-being, this convergence of forces raises a bunch of ethical and practical questions about lines between medical treatments and enhancements--for example, should employers allow, or even encourage employees to take pills to enhance concentration. As a speaker at our upcoming conference has described it, we face the challenge of understanding and thinking about what it means when people want to be better than well.

 

One of the keys to thinking about these dilemmas, I think, is to gain a better understanding of what sorts of practices people might adopt, with regards to enhancement therapy, and why. One answer, described in a 2008 paper is that "people were much more reluctant to enhance traits believed to be more fundamental to self-identity (e.g., social comfort) than traits considered less fundamental to self-identity (e.g., concentration ability)." Straightforward enough.

 

What struck me, though, about the study, led by Jason Riis, was a secondary finding: When the researchers changed the marketing language surrounding a medication, the distinction between fundamental and non-fundamental identity enhancement receded. As the authors write:

 

[W]e found that by framing enhancements as enablers of one’s true self, advertisers can successfully disarm the identity concerns that would otherwise prevent non-clinical individuals from enhancing a fundamental trait. In this light, it is interesting to consider the case of Paxil, an antidepressant sold by GlaxoSmithKline. Paxil has used the tagline “Paxil gets you back to being you” on its Web site. This tagline can, appropriately, ease the concerns of clinically depressed and anxious individuals who are considering taking this potentially helpful medication. At the same time, our research suggests that it could also increase the inclination of nonclinical individuals to seek a Paxil prescription for self-improvement purposes.

 

 

 

 

Ironically, as I was reading this study, I was listening to Pandora when an ad came on. "Do you suffer from shift work disorder?" the voice on the ad asked, before it directed me to something called the Wake Up Squad. By all indications, the wake up squad is connected to a pharmaceutical called Nuvigil, which people who work odd hours can take to manage their sleep cycles. Or, as the marketing department puts it, working as hard they can to convey the message of enabling the self, Nuvigil enables you to rediscover wakefulness.

 

 

 

 

I have to say that, at some level, I find the concept of "shift work disorder" to be absurd, as it effectively amounts to medicalizing a way of life. That said, I can certainly imagine why shift workers might have sleeping problems that can be aided by pharmaceuticals. Put differently, I can understand the need for the medication even though I think the marketing language is ridiculous.

 

The broader point here is that context and framing matter a lot when we attempt to answer questions about using medications for enhancement purposes. And in this sense, it won't be sufficient to understand sickness--we'll need to have a much more coherent framework for thinking about wellness.