Here’s a word you don’t usually hear: medicalization. What does it mean? It is defined as the act of medicalizing something. But what is medicalizing? Well, it’s the act of medicalization.

That should clear things up.

Circuitous jokes aside, I came across this term in the global health journal BMJ while researching modern practices of an age-old tendency in marketing. But before I explain that, I have a few questions for you:

Have you ever woken up in the morning feeling tired?

Do you occasionally feel irritable before eating breakfast?

Have you experienced soreness in your back lately?

Do you feel lethargy or fatigue in the afternoon?   

If you said yes to any of these questions, you are not alone. And you may be suffering from a condition that millions of adults, and even children, suffer from every day. Symptoms can be subtle at times but the issue is still real.

Ever experience sudden loss of short-term memory on the weekends?

How about neck stiffness at the office?

Thankfully, there is a cure, a product that could change your life. Derived from the best time-tested methods of holistic medicine, this product is all-natural, organic, and locally-sourced. So join me and hundreds more like us at the local conference hall this Saturday at 2:00 pm to hear more. Due to limited supply and tremendous demand, I’ll only be in town this Saturday, Saturday, SATURDAY to share this with you.  

You *Might* Be Suffering From …

In 2002, a journalist, general practice medical doctor, and professor of pharmacology teamed-up to write an important piece in the BMJ called Selling Sickness: The Pharmaceutical Industry and Disease Mongering. They brought attention to a frightening practice that dates at least as far back as 1800s. It comes down to the fundamental truth they acknowledge in the very first line:

A lot of money can be made from healthy people who believe they are sick.  

How do you get healthy people to think they’re sick? It’s easy. As the authors say, you just “widen the bounds of what constitutes a genuine medical condition.”

Case in point, the journal Therapeutics and Clinical Risk Management estimated in 2006 that 7 – 11% of the population suffers from the very real medical condition known as restless leg syndrome. It sounds terrible. But if you soften the criteria a little, you can capture 50% of the population really fast.

Ever toss and turn at night?

Ever find yourself unable to sleep a full eight hours?

Then you, too, might have restless leg syndrome. Emphasis on the term “might.” As in maybe. As in we’re not suggesting but we kinda are.

This gets to a tricky aspect of marketing on all fronts:

If you want to sell a cure, you must first sell the disease. That disease can be the medicalization of a common facet of biological life—but that’s just one small example. This practice of disease-mongering runs rampant in the diet and exercise industry, too. You can also find the practice in fashion, tech, real estate, and even in the arcane world of management consulting, as featured in the review of Matthew Stewart’s fabulous book The Management Myth. (See the section on whale hunts for more information.)

It’s sometimes deliberate but not always. Because even fake diseases are contagious. We’re all prone to be a Typhoid Mary about something. We’ll carefully, honestly, and nonetheless incorrectly diagnose our friends and loved ones.

So how does behavior this originate? I don’t know. But I think it starts with the misuse of an important factor of human behavior and storytelling.


Indeed! After all, a fake diagnosis (i.e. a “medicalized” condition) is nothing more than a story we tell ourselves. That story is compelling, attractive, and even a little addictive because of what it does with the most important ingredient of all stories, all narratives, and all marketing campaigns.

What is that ingredient?

I won’t tell you. Not yet.

Bad Novels

In my twenties, I wrote hundreds of short stories and four unpublished novels. When I look back on the material, I see that the writing was great but most of the stories were terrible. There are two lessons that I take from this. One, you can’t write alone and be effective (I never let others read these works, much to my detriment). Two, I hated doing anything bad to my characters. Which made for very boring stories.

If you ask any writer, regardless of genre, they’ll tell you that bad things must happen to your characters. But that’s just the start. It isn’t merely about creating A Series of Unfortunate Events; it’s about a series of unresolved and unfortunate events.

This is how great stories are made. The great mystery novel needs dead ends, red herrings, multiple suspects, and it cannot be really solved until page 289. The perfect narrative nonfiction needs surprises, slow train wrecks, coincidental mishaps and deliberate misdeeds. It is best when it culminates in a big, giant mess of still-unresolved problems that point to some narrow window of hope in the future.

Why is this tension so important? Because it is endemic to human curiosity. We have to see where this leads. Whatever “this” happens to be. Nothing engages a reader, or a market, more than tension. Nothing else compels the sell.

Fear Doesn’t Sell; Promises Do

This gets us to the brilliance of Seth Godin’s distinction between fear and tension in his book This Is Marketing. We often say that fear is a powerful thing. Fear works. And I guess that’s true. But only when you want to maintain the status quo. Because that’s what people do when they act out of fear: they defend, they conserve, they freeze up, they stay right where they are.

So yes, fear works if what you want is to do is keep things in place.   

But if you want to create change, which all marketers do, you need to consider Godin’s words:

Fear alone isn’t going to help you make change happen. Tension might, though.

The tension we face any time we’re about to cross a threshold. The tension of this might work versus this might not work. The tension of, ‘If I learn this, will I like who I become?’

There might be fear; but tension is the promise that we can get through that fear to the other side.

That last part is where the idea really takes shape. Tension is a promise. And this promise is what engages people to read a book especially because it starts with bad things happening to good characters. This promise is what makes people decide to buy a product, too.

The idea here gets to one of my favorite jokes of all time:

There are two things people don’t like in this world: they don’t like change and they don’t like the way things are.

This is more true than we care to admit. We want change. Just not that kind (i.e., the kind someone else chooses for us). Hence the tension. Your product or service is different, though. Or it should be. You offer a choice for a change that people can willfully choose. They will make that choice if it relieves the tension they feel between status quo and a certain kind of change.

This relief is a bargain to the buyer.

So do you occasionally suffer from dry tongue?

Have you found hair growing in your ears?

Do your ligaments occasionally make a popping sound when you move your joints?

If so, then you might suffer from a condition called Status Quo. Also known as Life-itis. And thankfully, there is a cure. It requires a choice, however. That choice is inherent in the product that I’m going to sell you. It’s a special product, one of limited supply. But if you act now I’ll also throw in a bonus cure for your other ailment, a condition called Fear. Together, these products provide you a Promise you’ve been looking for, an Assurance that things will get better.

But only if you act now. Operators are standing by.

Honest Sales

Honest work seeks positive change. Therefore, honest work already carries a promise. And a healthy tension. Which means that a great marketer doesn’t have to do “marketing” to make this tension apparent. It isn’t about gimmicks. But it is about technique.

A lot of people forget this. They think sales is shady business. But we disrespect the trade when we focus solely on the tricks.

You mustn’t lose the tension. You shouldn’t hide it either. It isn’t a fine line between a salesperson and a snake oil peddler. They both offer a promise but the gap between their methods is far greater than you think. So make a promise. Create the tension. So long as you can do what it takes to truly resolve it. Tension compels the sell. Just as surely as it compelled you to believe in the work. Being a marketer means being someone who helps others believe it, too.

Photo by Aditya Wardhana on Unsplash