The (mis) use of manufactured emotions

I had just outlined the core pieces of my insight-driven KAM approach when the sales director interrupted me.

“That sounds great. But we have recently started using a new conversation model when engaging stakeholders. It is focused on invoking emotions and connecting them to our treatment. We really need to make our doctors feel for the patients and select the treatment with the best data and the best chances of improving outcomes. How can we integrate that model into yours?”

I tried not to let out a deep sigh.

This was not the first time I had met a “conversation model” designed to stir up emotions in someone else.

The research has been clear on this for a long time.

Take the most studied of the manufactured emotions. Across 127 studies of fear appeals over fifty years, Tannenbaum’s 2015 meta-analysis found that fear works as a persuader only when three conditions line up at once. The threat must feel personal. The recommended action must feel like it will actually work. And the listener must feel capable of carrying it out. Miss even one and the appeal does not just fail. It backfires.

Most pharma deployments of emotion meet zero of the three.

Where the reflex came from

The “emotion drives decisions” line we now treat as marketing scripture came from Antonio Damasio’s work in the 1990s. He studied patients with damage to the part of the brain that integrates emotion with reasoning. They could not make even simple decisions. Emotion, he showed, is not the enemy of rational choice, it is the system that lets rational choice happen.

That was a real finding. It was also a finding about how individuals make decisions for themselves, not about how to make someone else feel something that is useful to you.

Marketing translated Damasio into “if it doesn’t move them emotionally, it won’t move them at all.” All this eventually entered into pharma and today this belief runs deep. Imagine your patient. Imagine the consequences. Imagine if you hadn’t acted in time…

In 2002 this was a reasonable conclusion of the research, but the science has moved on since.

What the research actually says

Witte’s Extended Parallel Process Model, refined across decades, sets out the conditions under which a fear appeal produces action versus avoidance. When threat is high but felt efficacy is low, listeners do not act. They suppress, dismiss, or detach. Tannenbaum’s 2015 meta-analysis of 127 studies confirmed it.

Friestad and Wright’s persuasion knowledge model, now in its fourth decade, showed that sophisticated audiences detect emotional manipulation and discount it. The more sophisticated the audience, the faster the detection.

Frosch and colleagues looked at the emotional reflex in pharma DTC advertising directly. The dominant audience response was not engagement, it was scepticism.

Loss aversion, the other piece of theory sales gurus reaches for, was Kahneman and Tversky’s finding about how individuals weigh their own gains and losses under uncertainty. It was not a finding about how to make a third party feel a loss on behalf of an absent patient. The framework does not transfer the way the emotional conversation model claim it does.

There is no serious modern research that supports the manufactured emotion approach.
But there is a large one telling us why it fails.

Manufactured emotion versus self-generated emotion

The thing we keep missing is the distinction between the emotion we try to install in a listener and the emotion the listener generates in themselves.

Manufactured emotion is what happens when a rep walks into a meeting carrying a story designed to make the HCP feel something specific. Concern. Urgency. Guilt about the patient who didn’t get the right treatment in time. The HCP, who has sat through several thousand of these meetings, sees the move coming. The persuasion knowledge model predicts exactly what happens next. The emotional content gets flagged as technique and the rest of the message gets discounted along with it.

Self-generated emotion is what happens when a question surfaces something the HCP already feels but has not put into words. The worry about the patient who slipped through the gap. The frustration with a pathway that does not let them act in time. The discomfort with a treatment plan they have been quietly questioning.

That emotion is not installed, it belongs to the HCP, not to us. And because it belongs to them, it moves them.

This is the engine underneath Motivational Interviewing. Across more than a hundred randomised trials, the majority show MI outperforming traditional advice. The direction has held for thirty years. The technique is not about making people feel things, it is about evoking what is already there.

What this means for the meeting

Stop trying to make HCPs feel things. They are already feeling things. The job is to ask the question that lets them say what they feel out loud, to themselves, and to us.

The shift in vocabulary tells you how far this is from current practice. Manufactured emotion training uses verbs like persuade, motivate, create urgency, deliver impact, get them to see. Research-backed training uses verbs like ask, listen, validate, reflect, surface, evoke.

Self-Determination Theory, Deci and Ryan’s framework with thousands of studies behind it, is even more direct. The motivators that actually drive sustained action in professionals are autonomy, competence, and meaning. Not fear, not guilt and not manufactured urgency.

A different kind of preparation

Imagine walking into the next stakeholder meeting with no emotional story prepared.

No patient anecdote calibrated for impact. No “what if” scenario designed to hit a nerve.

Instead, we have prepared something of value. A piece of analysis, a pattern in the data, a framing of the challenge they are already wrestling with, that we know is worth their time because we have done the homework.

We deliver it and then we ask for their perspective.

What do they see in their own patients? Where does this fit, and where does it not? What are they worried about that we have not put on the table?

Then we listen to learn what they actually think, and yes, what they actually feel, about a challenge that matters to both of us.

This is the difference between making someone feel something and earning the right to hear what they already feel.

What I told the sales director

So what did I answer the sales director who wanted me to integrate his new emotion-based conversation model into mine?

I did not enter into an argument about the effectiveness of his model. The research you just read applies inside our own organisations as much as it applies in the HCP meeting.

I told him: no problem. I will provide the KAMs with conversational content and context. How it gets delivered is up to you and your model.

That answer is doing two things at once. It avoids a long argument I couldn’t win and it bets that once the KAMs are holding real conversational material, the emotion-manufacturing model will quietly fall away on its own. The field knows what works.

The permission

If we have spent years training reps to manufacture emotion in the room, the data says we have been training them in a method that the most sophisticated audience in healthcare can spot in seconds.

See this as an invitation to retire a tactic that has been costing us trust, and to replace it with a discipline the research actually supports.

The patient story is not the tool.

The HCP’s own story is.