Fear and Loathing

Several people, who share my views about the misuse of fear to control behaviour in cardiac patients, emailed me about the British Heart Foundation’s (BHF) most recent campaign; “Watch your own heart attack” www.2minutes.org.uk
It is worth a look - if you don’t have angina and you don't believe the next breath could be your last. The short film is a natural progression of the earlier “doubt kills” poster campaign, in which a patient experiencing chest pain is graphically represented with a flesh-coloured belt crushing his chest. These are powerful interventions. On the face of it a campaign to raise people’s awareness of the presenting features of a heart attack makes sense. The vivid, highly professional portrayal of a patient having a heart attack is designed to be remembered and acted on and it is likely that many people will seek advice earlier because of the campaign. This could save lives.

So far so good, but what about the potential downside of such campaigns? Many patients have told me that they found the “doubt kills” campaign made them and their families more anxious. I recall a patient who described how he suddenly went into a panic when he saw the “doubt kills” poster on the way into hospital with a suspected heart attack. The sudden surge in adrenaline undoubtedly put him at greater risk and damaged more heart muscle. In other words the BHF “doubt kills” campaign, that was designed to reduce risk, had the opposite effect in that patient.

In my last blog I described how fear seems to dominate the lives of many angina sufferers and how professionals sometimes inadvertently make matters worse. Accidentally terrorising angina sufferers and their families is unfortunate. An expensively funded campaign that deliberately attempts to frighten patients and their families seems wrong. Anti-drinking, anti-smoking and anti-drugs campaigns that have used fear and disgust to discourage harmful behaviours are different because aside from the risks of glorifying the activities they seek to discourage, significant downsides are unlikely.

Unfortunately, as far as I know, the BHF is not planning to evaluate the potentially negative aspects of its campaign.

I'd be interested in your view.