This is my summary/translation of the article Abwehrreaktionen auf Gesundheitsappelle: Forschungsstand und Praxisempfehlungen by Hastall, 2012.

Against threatening or disturbing messages we have defensive processes, in order not to get thrown into a (unhealthy) state of frenzy every time we encounter one. These defensive processes are understood as motivated reactions, responses to health-appeals that take up resources when three criteria are met (Hastall, 2012).

1. The response follows directly after contact with the message
2. The response is based on defensive measures; it is meant to reflect an anticipated threat (e.g. threats to feelings of self-worth or emotional well-being)
3. The response is aimed directly or indirectly at avoiding the message or attacking the content of the message

We can distinguish four different groups of defensive responses that might inhibit effective health marketing/communication:

1. Avoiding or minimising contact with threatening messages
2. General psychological ego-defence mechanisms
3. Attacking the content of the message or the messenger
4. Increased health-damaging behaviour

Modern man has developed advanced avoidance strategies for online marketing messages of any kind to such a degree that we completely miss the advertisements on a website (a concept known as banner-blindness) and we install ad-blocking software, spam filters and the like to assist us in avoiding unsolicited content. Modern psychoanalysis and clinical psychology defines defence mechanismsas unconscious processes meant to protect an individual from fear and recognition of internal or external burdens and threats. A defence mechanism does this by regulating the response of the individual to emotional conflict and external burdens (Wittchen/Hoyer, 2011). Over 40 such processes have been discerned and are commonly and continually applied by individuals in their daily lives (Cramer, 2008). The mechanisms of denial, repression and rationalisation seem especially important in the health domain (Hastall, 2012).  For example; illusory superiority bias describes the constant overestimation of our positive aspects and the subsequent underestimation of our negative aspects. Combining this bias with unrealistic optimism and false consensus bias leaves many well intended health messages unattended to, because they are deemed ‘not relevant’ to us.

Should a possibly threatening message get through the first line of defence mechanisms and manage to get itself consciously considered, attack strategies might come into play. Findings that confirm this course of thought and action are aggregated from research into cognitive dissonance (Festinger, 1957), psychological reactance (Brehm, 1966; Dillard & Shen, 2005) and resistance (Jacks & Cameron, 2003).

Strategies to lessen the resistance

There are two neurological systems working in parallel: BIS and BAS (e.g. Carver et al. 2000; Gray, 1982). The Behavioural Inhibition System; looking for potential threats and possible dealing with them through various defence mechanisms – and the Behavioural Activation System; looking for cues for potential positive experiences. BIS concerns itself with (our protection from) negative emotions. Any message that intends to trigger certain health behaviours would do well to address both systems, simultaneously trying to minimize BIS while maximizing BAS (Knowles & Linn, 2004) Minimizing the threat– All health related sciences tend to take the perspective of the ‘Natural model’ of health vs. disease and mainly focus their efforts on the physical. However, a health related message can be perceived as threatening on more levels than just as it relates to our physical manifestation. All the possible levels of threat must be discerned if they are to be minimized.

References

Brehm, J. W. (1966): A Theory of Psychological Reactance, New York: Academic Press. Carver, C. S., Sutton, S. K., & Scheier, M. F. (2000). Action, emotion, and personality: Emerging conceptual integration. Personality and social psychology bulletin, 26(6), 741-751.
Cramer, P. (2008): Seven Pillars of Defense Mechanism Theory, in: Social and Personality Psychology Compass, 2, 5, S. 1963-1981
Dillard, J. P./Shen, L. (2005): On the Nature of Reactance and Its Role in Persuasive Health Communication, in: Communication Monographs, 72, 2, S. 144-168.
Festinger, L. (1957): A Theory of Cognitive Dissonance, Stanford: Stanford University Press.
Gray, J. A. (1982). The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system. New York: Oxford University Press.
Hastall, M. R. (2012). Abwehrreaktionen auf Gesundheits-appelle: Forschungsstand und Praxisempfehlungen. In S. Hoffmann, U. Schwarz & R. Mai (Eds.), Angewandtes Gesundheitsmarketing (pp. 281-296): Springer Fachmedien Wiesbaden. Jacks, J. Z.
Cameron, K. A. (2003): Strategies for Resisting Persuasion, in: Basic & Applied Social Psychology, 25, 2, S. 145-161 Knowles, E. S.
Linn, J. A. (2004): Approach-Avoidance Model of Persuasion: Alpha and Omega Strategies for Change, in: Knowles, E. S./Linn, J. A. (Hrsg.): Resistance and Persuasion, Mahwah: Psychology Press, S. 117-148.
Wittchen, H.-U./Hoyer, J. (2011): Klinische Psychologie & Psychotherapie, Berlin: Springer.