Faced with declining vaccine uptake, or attacks on medics managing the Ebola crisis in DRC, it is tempting to rail against others’ irrationality. Why do people believe rumours or conspiracy theories? What has happened to faith in medical progress? But it is worth taking a step back, and recognising that, for most of us, irrational beliefs continue to help us make sense of misfortune.
In The Year of Magical Thinking, Joan Didion reflects on the aftermath of her husband’s death, and daughter’s serious illness. The year ‘cut loose any fixed idea’ she had about the finality of the division between life and death. Grief brought jarring misalignments between her cool, objective beliefs about the world – and the power of language to articulate them – and the constant eruptions of magical thinking. Recalling the credo of her Episcopalian upbringing (‘I believe in the Holy Ghost…’) she realizes ‘I had never believed in the words […] I did not believe in the resurrection of the body’. Yet this disavowal of supernatural thinking brought no clarity or solace. The year was marked by her failure to let her husband go fully into the world of the dead. She pores over the material traces he left for the living in his death, and the traces of impending death in his life: pencil marks, open books and inevitable other omens. During the year, Didion’s avowal of rationality comes profoundly unstuck: if luck plays no part in our histories, for which we are properly accountable and responsible, then why is her daughter sick and her husband dead? Grief unsettles not because beliefs are shaken – but because they are revealed, in all their complex contradictions.
Magical thinking is not just the preserve of those in extremis. A training exercise for would-be therapists asks participants to write down the name of someone they love; then a time and date, not too far in the future. Beneath, they are asked to write down the manner of their loved one’s death at that time. The discomfort (indeed impossibility, for many) of the task demonstrates the porous line between the normal and the pathological; between our rational and superstitious selves. It is not only the bereaved or the dysfunctional obsessives who believe in magic. Most would claim to eschew the notion that our thoughts or writings can directly affect the material world. Yet clearly traces of such beliefs remain: something tugs (and tugs hard) at our desire not to ‘tempt fate’.
This impossible task reveals something of the complexity of beliefs that underpin our health practices. Some layers are buried deep: abject and shameful. Even relatively legitimate non-rational beliefs, such as those expressed in religious credo, articulate awkwardly with our more objective, empirical bodies of knowledge. Yet acknowledged or not, the remnants of pagan and religious doxa continue to structure the rhythms of our weeks and years – and they can erupt unexpectedly to infuse our moral reckonings with the contingencies of misfortune.
These other, less rational, beliefs, can matter as much to our health practices as biomedical knowledge. An excess of magical thinking can become intolerable anxiety about controlling the world through actions; the revelations of the limits to rationality is one of grief’s many burdens. As a wealth of sociological research shows, in more everyday contexts beliefs about moral deservingness, luck and fate still jostle with our understandings of viruses, genes and statistical probability in how we account for who gets a common infection, or cancer or heart disease. More knowledge does not erase these other frameworks for understanding an unpredictable universe, but rather accretes, layering on top.
Failures to take up vaccination, or eat healthful foods, or obey medical regimes, have all been framed as, at least in part, the outcomes of unhelpful beliefs. Decades of scholarship on health beliefs has studied the links between what people think and what they do. Much of this research attempts to elicit beliefs (about the likely risks and benefits of actions, about powerful others, about our ability to control our own health, for example) from answers to questions on surveys or interviews – accessing only those that can be recognised, articulated and reported. As Didion’s account suggests, such reporting may be a thin, and deeply misleading, guide to the beliefs that matter. But if the beliefs that matter are only revealed to the self, let alone to an interlocutor, in the midst of crisis, how can they be known?
What people do in disrupted times provides some evidence. The global COVID-19 pandemic was, for many, a disruptor. Everyday competence – in how to manage acceptable norms of hygiene, or social interaction – was thrown into chaos, as both experts and laity scrambled to learn to live with a virus and its impact. A certain hysteresis accompanied slippage between habitus and new, uncertain, fields of practice. Anxieties about false beliefs proliferated alongside viral replication. Rumours and fake news were positioned as, in themselves, threats to the public health. As anxieties collided around the uncertain promise of medical science and trust in governance, one particular set of beliefs, ‘conspiracy’ beliefs, became a particular concern. A study in the UK, for example, found that greater use of ‘unregulated social media’ correlated with likelihood of believing conspiracy theories, and that these in turn correlated with less likelihood of conforming with ‘evidence-based’ risk reductions. Conspiracy beliefs were evidenced by agreement with statements such as ‘The symptoms of COVID-19 seem to be connected to mobile 5G network radiation’. That a belief was ‘faulty’ was evidenced by the lack of scientific warrant for its truth-status and the lack of credentialed authority for their provenance.
Yet in chaotic times the ever-porous boundary between knowledge and belief becomes even more treacherous. Normal science moves slowly, and typically only settled consensus is widely shared across public discourse. Pandemic times are not normal; science speeds up, and it moves under the public gaze. In the COVID-19 pandemic, the uncertainties of virology, epidemiological modelling and therapeutic evaluation were revealed in real time, with high levels of media scrutiny. Before scientific debates coalesce into stable knowledge, the usual rituals of legitimacy – the evidential warrants from peer review, for instance – fail to reassure. In such contexts, argued Collins and Evans , scientific knowledge becomes public currency, with everyone entitled to a view, and to question the legitimacy of expertise. If knowledge claims conventionally rest on justification and evidence, these may be in shorter supply than usual. Believing 5G causes infection may not be a warrantable claim, yet credentialed scientists were also calling for caution in the face of limited evidence on the safety of 5G roll out , and scientific consensus about the original triggers for the spread of a coronavirus had not stabilised. What were at one point irresponsible conspiracy beliefs – that the virus was circulating in Europe way earlier than officially thought – later became legitimate scientific hypothesis.
If studying beliefs in the COVID-19 pandemic remained largely the preserve of psychologists, earlier pandemics drew in the expertise of those trained to look at belief as meaningful, rather than as faulty thinking. Anthropologists working in west Africa during the 2014-15 Ebola epidemic noted the dangers of simply taking conspiracy beliefs as indicators of misinformation or culture, rather than as expressions of political and social realities. Who is seen to be leading on disease control matters – in terms of legitimacy and trust, and congruence between rival national and local political administrations. Rumours (of political parties utilising disease to kill rival supporters; of colonial masters stealing blood) may be beliefs as lacking in empirical evidence as that of the role of 5G in virus spread. But they represent robust knowledge of the social order, and need to be taken seriously as such. Anthropologists studying Ebola were largely working away, not at home. In our own contexts, it can be harder to recognise that (others) different beliefs can be truths about something, even if that something is not immediately manifest.
What constitutes evidence of a belief, and what constitutes evidence of its status as belief rather than knowledge, is malleable. Beliefs may be revealed in crises – but this is when their status as belief not knowledge is most unstable. In more normal times, beliefs that shape our responses to misfortune, and our ways of sustaining wellbeing, remain deeply buried, unrecognised perhaps even by the believer. Didion notes her motivation for documenting her year of magical thinking: ‘I need whatever it is I think or believe to be penetrable, if only to myself’. Even for a writer of Didion’s skill, this is a challenge. To articulate (and hear) the unsayable, and often unknowable, requires a sociological methodology attuned to multiple levels of meaning and belief. If we are facing a crisis of faith in biomedicine, we should resist simply denouncing irrationality, but instead attend to the rationality of irrational beliefs.
An earlier version of this piece was published as part of the Wellcome Trust funded Index of Evidence. It is reproduced here under Creative Commons licence.
On (irrational) health beliefs
by Judy Green Jun 3, 2026Faced with declining vaccine uptake, or attacks on medics managing the Ebola crisis in DRC, it is tempting to rail against others’ irrationality. Why do people believe rumours or conspiracy theories? What has happened to faith in medical progress? But it is worth taking a step back, and recognising that, for most of us, irrational beliefs continue to help us make sense of misfortune.
In The Year of Magical Thinking, Joan Didion reflects on the aftermath of her husband’s death, and daughter’s serious illness. The year ‘cut loose any fixed idea’ she had about the finality of the division between life and death. Grief brought jarring misalignments between her cool, objective beliefs about the world – and the power of language to articulate them – and the constant eruptions of magical thinking. Recalling the credo of her Episcopalian upbringing (‘I believe in the Holy Ghost…’) she realizes ‘I had never believed in the words […] I did not believe in the resurrection of the body’. Yet this disavowal of supernatural thinking brought no clarity or solace. The year was marked by her failure to let her husband go fully into the world of the dead. She pores over the material traces he left for the living in his death, and the traces of impending death in his life: pencil marks, open books and inevitable other omens. During the year, Didion’s avowal of rationality comes profoundly unstuck: if luck plays no part in our histories, for which we are properly accountable and responsible, then why is her daughter sick and her husband dead? Grief unsettles not because beliefs are shaken – but because they are revealed, in all their complex contradictions.
Magical thinking is not just the preserve of those in extremis. A training exercise for would-be therapists asks participants to write down the name of someone they love; then a time and date, not too far in the future. Beneath, they are asked to write down the manner of their loved one’s death at that time. The discomfort (indeed impossibility, for many) of the task demonstrates the porous line between the normal and the pathological; between our rational and superstitious selves. It is not only the bereaved or the dysfunctional obsessives who believe in magic. Most would claim to eschew the notion that our thoughts or writings can directly affect the material world. Yet clearly traces of such beliefs remain: something tugs (and tugs hard) at our desire not to ‘tempt fate’.
This impossible task reveals something of the complexity of beliefs that underpin our health practices. Some layers are buried deep: abject and shameful. Even relatively legitimate non-rational beliefs, such as those expressed in religious credo, articulate awkwardly with our more objective, empirical bodies of knowledge. Yet acknowledged or not, the remnants of pagan and religious doxa continue to structure the rhythms of our weeks and years – and they can erupt unexpectedly to infuse our moral reckonings with the contingencies of misfortune.
These other, less rational, beliefs, can matter as much to our health practices as biomedical knowledge. An excess of magical thinking can become intolerable anxiety about controlling the world through actions; the revelations of the limits to rationality is one of grief’s many burdens. As a wealth of sociological research shows, in more everyday contexts beliefs about moral deservingness, luck and fate still jostle with our understandings of viruses, genes and statistical probability in how we account for who gets a common infection, or cancer or heart disease. More knowledge does not erase these other frameworks for understanding an unpredictable universe, but rather accretes, layering on top.
Failures to take up vaccination, or eat healthful foods, or obey medical regimes, have all been framed as, at least in part, the outcomes of unhelpful beliefs. Decades of scholarship on health beliefs has studied the links between what people think and what they do. Much of this research attempts to elicit beliefs (about the likely risks and benefits of actions, about powerful others, about our ability to control our own health, for example) from answers to questions on surveys or interviews – accessing only those that can be recognised, articulated and reported. As Didion’s account suggests, such reporting may be a thin, and deeply misleading, guide to the beliefs that matter. But if the beliefs that matter are only revealed to the self, let alone to an interlocutor, in the midst of crisis, how can they be known?
What people do in disrupted times provides some evidence. The global COVID-19 pandemic was, for many, a disruptor. Everyday competence – in how to manage acceptable norms of hygiene, or social interaction – was thrown into chaos, as both experts and laity scrambled to learn to live with a virus and its impact. A certain hysteresis accompanied slippage between habitus and new, uncertain, fields of practice. Anxieties about false beliefs proliferated alongside viral replication. Rumours and fake news were positioned as, in themselves, threats to the public health. As anxieties collided around the uncertain promise of medical science and trust in governance, one particular set of beliefs, ‘conspiracy’ beliefs, became a particular concern. A study in the UK, for example, found that greater use of ‘unregulated social media’ correlated with likelihood of believing conspiracy theories, and that these in turn correlated with less likelihood of conforming with ‘evidence-based’ risk reductions. Conspiracy beliefs were evidenced by agreement with statements such as ‘The symptoms of COVID-19 seem to be connected to mobile 5G network radiation’. That a belief was ‘faulty’ was evidenced by the lack of scientific warrant for its truth-status and the lack of credentialed authority for their provenance.
Yet in chaotic times the ever-porous boundary between knowledge and belief becomes even more treacherous. Normal science moves slowly, and typically only settled consensus is widely shared across public discourse. Pandemic times are not normal; science speeds up, and it moves under the public gaze. In the COVID-19 pandemic, the uncertainties of virology, epidemiological modelling and therapeutic evaluation were revealed in real time, with high levels of media scrutiny. Before scientific debates coalesce into stable knowledge, the usual rituals of legitimacy – the evidential warrants from peer review, for instance – fail to reassure. In such contexts, argued Collins and Evans , scientific knowledge becomes public currency, with everyone entitled to a view, and to question the legitimacy of expertise. If knowledge claims conventionally rest on justification and evidence, these may be in shorter supply than usual. Believing 5G causes infection may not be a warrantable claim, yet credentialed scientists were also calling for caution in the face of limited evidence on the safety of 5G roll out , and scientific consensus about the original triggers for the spread of a coronavirus had not stabilised. What were at one point irresponsible conspiracy beliefs – that the virus was circulating in Europe way earlier than officially thought – later became legitimate scientific hypothesis.
If studying beliefs in the COVID-19 pandemic remained largely the preserve of psychologists, earlier pandemics drew in the expertise of those trained to look at belief as meaningful, rather than as faulty thinking. Anthropologists working in west Africa during the 2014-15 Ebola epidemic noted the dangers of simply taking conspiracy beliefs as indicators of misinformation or culture, rather than as expressions of political and social realities. Who is seen to be leading on disease control matters – in terms of legitimacy and trust, and congruence between rival national and local political administrations. Rumours (of political parties utilising disease to kill rival supporters; of colonial masters stealing blood) may be beliefs as lacking in empirical evidence as that of the role of 5G in virus spread. But they represent robust knowledge of the social order, and need to be taken seriously as such. Anthropologists studying Ebola were largely working away, not at home. In our own contexts, it can be harder to recognise that (others) different beliefs can be truths about something, even if that something is not immediately manifest.
What constitutes evidence of a belief, and what constitutes evidence of its status as belief rather than knowledge, is malleable. Beliefs may be revealed in crises – but this is when their status as belief not knowledge is most unstable. In more normal times, beliefs that shape our responses to misfortune, and our ways of sustaining wellbeing, remain deeply buried, unrecognised perhaps even by the believer. Didion notes her motivation for documenting her year of magical thinking: ‘I need whatever it is I think or believe to be penetrable, if only to myself’. Even for a writer of Didion’s skill, this is a challenge. To articulate (and hear) the unsayable, and often unknowable, requires a sociological methodology attuned to multiple levels of meaning and belief. If we are facing a crisis of faith in biomedicine, we should resist simply denouncing irrationality, but instead attend to the rationality of irrational beliefs.
An earlier version of this piece was published as part of the Wellcome Trust funded Index of Evidence. It is reproduced here under Creative Commons licence.