Reassurance through normalization inadvertently suppresses treatment

Abstract

One way in which healthcare providers communicate reassurance is by informing patients when their symptoms are normal, either for a particular life stage (for example, menopause) or health context (for example, postprocedural pain). Although reassurance aims to reduce anxiety and bolster self-efficacy, which are factors that generally facilitate action, our results suggest that normalization can paradoxically have the opposite effect, reducing people’s inclination to pursue treatment. A total of 14 studies (n = 9,371) document this phenomenon, including when and why it occurs. Here we find that normalization triggers a reappraisal of treatment norms, where people infer that their healthcare provider is normalizing their symptoms to communicate that treatment is not warranted. As this is typically not providers’ intention, we also identify communication strategies to overcome this faulty inference. While these experiments demonstrate a consistent effect across many samples, they should be interpreted in light of the experiments being conducted online, rather than in a clinical setting. Across 14 studies, the authors show that when clinical providers offer reassurance through normalization, this can have paradoxical effects on patients, reducing their inclination to pursue treatment.