Why understanding neurobiology is the key to behavior change

We talk to Nano associate Shawn Kant, currently a senior Neuroscience major at Brown University’s Program in Liberal Medical Education (PLME), about his research into a viable model to engender effective behavioral shifts towards better health outcomes. Kant’s work draws on Aristotle’s “Ethos, Logos and Pathos” and recent discoveries about the human brain to add gravitas to the 5 x Cs: Connection; Control; Coherence; Cognitive Targeting; and Change. Here are edited and condensed excerpts of our conversation. 

Shawn Kant, you spent time with us here at Nano this past summer working on research projects, delivering a model for behavior change through a deep understanding of neurobiology – which starts with the Greek philosopher Aristotle (384 – 322 B.C.E.). Tell us about his work and why it inspired you.
[SK] It was Aristotle who developed many framework principles of argumentation: ethos (credential), pathos (emotional) and logos (logical). These three elements of a well-constructed argument will appeal to the person listening on multiple levels to convince them of the efficacy of the reasoning, and – in our case at Nano – to hopefully change their behaviors around health and wellness. 

Can you give us an example of ethos-pathos-logos in action?
[SK] Absolutely. A good example of Ethos is a presenter starting by describing their personal pedigree and accomplishments to establish credibility. This affects audience perception – we are more inclined to listen to their argument. Pathos is often conveyed best in tone and through visuals, such as a springtime meadow on a PowerPoint slide, with the goal of making an audience feel what you want them to feel. Then Logos is all about logic and reason – citing facts, statistics, and backing up the argument through the use of reason and proof. 

Can you give us a brief example of how a health and wellness company could use ethos-pathos-logos in their messaging – before we move onto the other part of your model: the 5 x Cs?
[SK] I’d recommend connecting with healthcare providers for product endorsements, and displaying federal and state regulatory approvals in an easily noticeable location on the homepage of the company website. Use direct, vivid language in clearly visible locations and emotion-evoking images to demonstrate the product’s popular appeal and effectiveness. Consider using personal testimonials, with accompanying images, of users of your product. For logos, present arguments in a simple, direct fashion and use deductive reasoning to guide the audience towards the rational conclusion that a behavior change facilitated by your platform is in their best interest. 

And your point is that by using a combination of all three, as humans, we’re persuaded – almost subconsciously – to fall in line with our best interests.
[SK] Yes, that’s exactly it. As Aristotle argued, a well-reasoned argument, incorporating ethos, pathos and logos, is a very effective model. Of course, ethos-pathos-logos are wide ranging concepts and there is lots of nuance in how to effectively blend them together, as the 5 x Cs reflects. Ultimately though, this really is the foundation of effective communication, and the basics haven’t changed much from ancient Greece up to today.

Let’s move onto the 5 x Cs which you used as a framework, together with ethos-pathos-logos, to really shift behaviors for better health outcomes. Tell us about these.
[SK] The 5 x Cs are Coherence (simple, direct, visually appealing information presentation tied to tangible, personal impact value); Control (placing people in control of a diverse array of interacting streams of information); Connection (between communities of like-minded individuals); Cognition: (message campaigns targeting the reward circuitry and the dorsomedial prefrontal cortex) and Change: (manageable, incremental change, avoiding the perception of force). 

You also mentioned “pleasure” – how does this factor into the model?
[SK] That’s true. Well, pleasure is used in gamification because the fun factor links stickiness to habit formation by activating important brain circuits in regions called the limbic system and the prefrontal cortex. This kind of self-processing activity promotes change.

Now let’s go to your model validation – can you give us an example of how this all fits together – the 5 x Cs + ethos-pathos-logos by using a case study, perhaps of a young woman in the first trimester of pregnancy. Let’s imagine she’s come to Nano looking for help and guidance – how do we deploy your model to get her happy and healthy?
[SK] First of all we want to establish Coherence in all our messaging to her – emphasizing the importance of a healthy lifestyle while pregnant. 

Keeping top of mind: “I’m going to get into my healthiest state during this pregnancy for myself and my baby” and, by doing that, we get her to “invest” in positive change?
[SK] Exactly. Then we’d bring in Ethos – citing experts who work with Nano and providing statistics to give her a sense of our credibility and knowledge, perhaps something about the high degree of susceptibility of a developing child to biological and environmental stressors and pollutants. Then add in Pathos, perhaps with video/audio/textual testimonials of mothers who used Nano to make real shifts in their health/wellness, showing that the platform had a meaningful positive impact on their lives. Logos could be used through providing scientific references, informative videos and specific infographics that, for example, show the developmental stages of mother and baby and reinforce the need to invest time in healthy prenatal care. 

How does “control” factor into her experience of Nano?
[SK] Control is all about placing her in a position to access to the knowledge and confidence necessary for change at her own convenience.

She doesn’t feel bombarded by unwelcome messaging – but can select what data she’d like to receive, and when?
[SK] Yes, that’s very important. Humans don’t change behavior if they feel coerced or forced into it. For example, getting a genetic test is a good idea at this stage of life. But rather than delivering a blanket statement like that, it’s better to explain how different means of genetics tests work (i.e. genotyping vs sequencing); how one interprets data; provide information on the common biomarkers used in health and wellness test for assessing complex things like kidney function, and scientific validity of each marker. Throughout communication to change behavior we want to go back to coherence – emphasizing the positive outcome each time. 

How about “Connection”?
[SK] This is vital in creating social reinforcement that supports behavioral change and healthy habits – and has special strength when applied to a first-time pregnant mother. She needs to feel part of a like-minded group supporting her, not judging her, especially if she’s trying to make massive changes like quitting smoking or moving from junk food to healthier choices. Forums are crucial in providing support and allowing individuals with similar circumstances and/or experiences to give advice/ask questions to each other. If you want proof, just think about how popular pregnancy forums are!

Talk us through “Cognition” now.
[SK] Now we’re getting into some great neuroscience. Basically, this centers on targeting important brain areas including the prefrontal cortex, limbic system, and reward circuitry. It links strongly to pathos appeal, based on structural and functional brain changes that occur during pregnancy. These changes, recorded in many neuroimaging studies, seem to make an expectant mother more sensitive to their baby’s emotions, avoiding threats, general social cognition, and so on. To encourage a behavior change in an expectant mom, especially a first-time mother who has no experience with the neurobiological changes occurring during pregnancy, consider targeting her reward circuit by using infant images, baby toys, and baby noises. Also consider pairing sensory cues and self-referential processing to engage the prefrontal cortex, because prefrontal cortex activation can “tell you what you want before you know you want it”. 

Give us an example.
[SK] A way to engage the prefrontal cortex might be gentle reminders (both visual and textual) about the importance of fruits and vegetables as it will make them feel happier and ultimately increase the odds of delivering a happy and healthy baby.

Subliminal messaging?
[SK] Sort of – but in a good way.

Good point. How else can you use cognition with the prefrontal cortex?
[SK] During pregnancy, the prefrontal cortex and limbic systems may also be strongly activated in threat detection, so you might also be able to activate the prefrontal cortex by emphasizing how important a behavior change is in stark terms of the baby’s prenatal and postnatal health. The easiest example is showing, in emotional terms, why smoking is so horrible to a developing baby. This connects to the heightened activation of empathy and social cognition circuitry in the brains of pregnant women.  

Finally, “Change”?
[SK] Yes – change occurs when you bring everything together – ethos-pathos-logos plus coherence, cognition, control and connection. These elements address all aspects of a human behavioral systems and enable us to help people shift behaviors for good. By this point, hopefully, the user now has the confidence that they need to make the change they desire, and can accomplish this change using the platform. 

And how do you keep them coming back to ensure the changes “stick”?
[SK] By having a constant dialog with them. By setting realistic milestones, with awards for achieving each milestone and using a variable reinforcement schedule (i.e. rewards at random moments), to promote adherence to a newly formed routine.

Making them feel good in their reward circuitry for following the program?
[SK] Exactly. But, above all else, it’s crucial not to do anything that might convey the impression of forcing behavioral change on the user! 

It has to be their choice – or it won’t be a permanent shift?
[SK] That’s the key – but deploying ethos-pathos-logos plus the 5 x Cs (coherence, control, connection, cognition and change) – is a way to engage the human behavioral circuits at a very deep level.

Shawn – thanks for talking with us today – and best of luck with your studies. Come visit us back in Austin, TX, soon.
[SK] Thank you and will do!