Burden of choice

Barry Schwartz’s book became a page-turner for me when he began discussing a survey of preferences in medical care. The majority of nonpatients said they would want to be in charge of their treatment if they were to get cancer, he reported. But most of those who actually had cancer wanted their doctors to take over.

“What looks attractive in prospect doesn’t always look so good in practice. In making a choice that could mean the difference between life and death, figuring out which choice to make becomes a grave burden,” Schwartz states. Simply put, the paradox is that while having some choice is necessary and healthy, too much choice—too many options, too many decision points—is debilitating.

Two years ago I was diagnosed with lung cancer. Absorbed in my work, active in church, a happy husband and grandfather, physically fit but for the inevitable insults of aging, I was completely unprepared when I was told that I had this dreadful disease. From the team of specialists to whom my primary-care physician referred me, I soon learned that the cancer had spread too far for a simple surgery. Having no reason to doubt the wisdom of the aggressive regimen the specialists recommended, my wife and I agreed that I would receive a combination of chemotherapy and radiation, to be followed, if all went well, by surgery and a second round of chemotherapy. Treatment began two weeks after the first hint of trouble.

By no means did we simply leave everything to the doctors. We reached out to family, fellow parishioners and friends near and far for practical and spiritual support. We prayed and were prayed over. We stocked up on multivitamins, and I kept up my exercise. We received advice from my sister, herself a cancer survivor and volunteer counselor, and prepared questions for the doctors, showing up for appointments with notepads and a tape recorder. We talked everything over between us and made the most of each day. I joined a support group at the hospital and began to record my thoughts in an ongoing chronicle. But we did not go on the Web to research treatment options. We wanted to get on with the treatment my doctors had recommended.

In the weeks and months that followed, we received an abundance of help for which we’ll always be grateful. I was especially encouraged to learn how many members of our church were, or knew of, cancer survivors. Having lost many family members to cancer, I did not need to hear about the toll this disease takes. Nor did I find it helpful to be asked if I had tried or if I knew about someone’s favorite anticancer nostrum, from beverages to alternative healers. Though these suggestions were sincere and expressed a desire to help, I soon found them downright irritating.

When it comes to making decisions about cancer treatment, I appear to be what Schwartz would call a “satisficer,” one who is willing to live with the “good enough” rather than insisting on the “best.” Schwartz borrowed this concept from Nobel laureate Herbert Simon, who developed it as a realistic alternative to the notion of the “utility maximizer” presupposed by classical economics. For example, if a supermarket chain attempted to calculate the very best alternative before deciding where to place a new store, the research costs would bankrupt it, while more intrepid competitors would move in. In business, “satisficing” may be good enough to yield profitable results. Research has shown that offering consumers too many flavors of jam (two dozen instead of a half dozen) depresses sales. Beyond a certain point, options are paralyzing.

A professor of psychology and social theory at Swarthmore College, Schwartz applies Simon’s ideas to the human psyche, with happiness replacing profitability as the desired outcome. (An excerpt from the book, focusing on the happiness/misery calculus, appeared in the April issue of Scientific American, under the title “The Tyranny of Choice.”) Schwartz and his colleagues developed a “maximization scale,” by means of which subjects rate their relative maximizer/satisficer proclivities. People are asked to rate themselves on a seven-point scale from “completely agree” to “completely disagree” with such statements as, “When shopping, I have a hard time finding clothing that I really love” or “Whenever I watch TV, I channel surf.” Most people cluster near the middle in such scales, but 10 percent of Schwartz’s subjects were classified as extreme maximizers, those who think long and hard about every decision. They tend to make objectively better decisions than the rest of us, but they are less satisfied both with what they’ve chosen and with life in general.

Choice, something Americans expect to exercise in everything from TV programs to marital partners, is hardly a bad thing in itself. Schwartz cites studies of laboratory animals that are allowed to escape or prevented from escaping from unpleasant conditions. Those given no options not only languish, but develop an incapacity to respond to any improvement in their circumstances. To be deprived of all choice is to be brutalized. Yet beyond a certain point more choice means less happiness. The more choices we ponder or the more time we invest in making a certain choice, the worse we tend to feel.

Schwartz cites several reasons for this, drawing on research in psychology and in behavioral economics. Researchers in the latter field have known for some time that people don’t think like adding machines, tallying up potential positive and negative outcomes (“gains” and “losses”), but feel worse about a given unit of loss than about a corresponding unit of gain. And when we contemplate a choice (this or that, yes or no), we know that doing one thing means foregoing another. Foregone alternatives—“opportunity costs,” in economists’ terms—are losses. Because maximizers think about more alternatives, or think more about alternatives, they also experience more opportunity costs, the sum of which may be greater than the gain from the chosen alternative. They’ve programmed themselves to be acutely aware of what they’re not getting.

To make matters worse, much in our emotional makeup robs us of satisfaction with the choices we make. Regret over a bad choice can take away satisfaction, but the determination to avoid bad choices leads to overinvestment in the decision process. Social comparison means that our satisfaction is predicated on what others have. Schwartz cites research showing that the majority of people would rather be big fish in small ponds, earning $50,000 when others earn $25,000, than small fish in big ponds, earning $100,000 when others earn $200,000. (Many ministers’ families can relate to this!)

Most insidious of all is hedonic adaptation. Whenever we find something that does make us happier, we eventually get used to it, and our sense of well-being returns to where it was before the new thing came into our lives. We can never make progress on the hedonic treadmill. (The good news in adaptation is that it also works for things that lessen the quality of life. We get used to them, too. People with chronic diseases and missing limbs move to a new threshold of well-being.)

If this is human nature, a late-capitalist, consumer-driven economy seems designed to torture us. Schwartz glimpsed this possibility when, as a middle-aged man, he went to a Gap store and naïvely asked for a new pair of blue jeans. The clerk asked if he wanted slim fit, easy fit or relaxed fit; regular or faded; stone-washed or acid-washed; button-fly or regular fly. Spending much longer in the store than he’d planned, investing “time, energy, and no small amount of self-doubt, anxiety and dread,” he eventually settled on “easy fit.” Piqued by this experience, he made a loose inventory of his local supermarket, where he found 85 varieties of crackers and 285 of cookies, 230 different soups, 120 pasta sauces and 175 kinds of salad dressing. A book on American consumerism told him that the typical supermarket carries more than 30,000 items. He began to suspect that at some point “choice no longer liberates. It might even be said to tyrannize.”

Predictably, the answer to Schwartz’s dilemma offered by one reviewer was for consumers to maintain loyalty to specific brands. Since I do the grocery shopping in my family, I know that brands are part of the problem, not the solution. Covetous of shelf space, companies multiply options within familiar brands, so that it is not sufficient for my wife simply to put Tide or Cheerios on the shopping list. The problem is systemic.

Schwartz offers several ways of dealing with the paradox of choice, and unlike some would-be Jeremiahs he does not drag the reader through an endlessly bleak landscape before finishing on a note of half-hearted hope or apocalyptic despair. Early on, he introduces the contrast between maximizing and satisficing, and he salts the book with hints on to how to move from the one mind-set to the other. Beware of the “new and improved.” Make it a rule to visit only two stores before buying clothing. Continue to read advertisements for the car you just bought, ignoring what the competition has to say. Decide on the kinds of choices you’re willing to think through—areas in which it is fun to choose (for me, movies and wine), in contrast to those in which deciding is burdensome and a good-enough outcome will do. Allow other people to be the innovators, trying things out for you. “Remember that ‘he who dies with the most toys wins’ is a bumper sticker, not wisdom.” Well-chosen New Yorker cartoons are used in the book to temper the argument with wry and gentle wit.

Schwartz mostly offers wisdom of a worldly sort, but he approaches things of the spirit when he suggests keeping an ongoing list of the good things that happen each day, big and small, in order to inculcate an “attitude of gratitude.” “With practice, we can learn to reflect on how much better things are than they might be, which will in turn make the good things in life feel even better.” Chicago philosopher-comic Aaron Freeman made the same point in a recent National Public Radio commentary: “Gratitude ameliorates the worst aspect of American life, which is that the consumer culture makes us constantly aware of what we do not have, without counterbalancing rituals of gratitude for the mind-boggling bounty that is the U.S.A. . . . As you are grateful, to that precise extent you are happy.”

Schwartz comes closest to a classically religious attitude when he enjoins the love of constraint and the power of nonreversible decisions, especially with respect to life’s most important decisions. He relates the story of a minister who, in a sermon on marriage, shocked his congregation with the frank acknowledgment that, yes, the grass is greener on the other side. No matter whom you marry, inevitably there will be someone younger, funnier, smarter, wealthier or more empathetic than he or she is. But marriage is not a matter of comparison shopping. “The only way to find happiness and stability in the presence of seemingly attractive and tempting options is to say, ‘I’m simply not going there. I’ve made my decision. I’m not in the market—period.’ . . . Wondering whether you could have done better is a prescription for misery.” Considering your decision irreversible allows you to pour your energy into making your marriage better.

Research shows that people with strong social bonds—those who are married or enjoy close family and church ties—tend to be happier and healthier than those lacking such bonds. But Schwartz thinks it’s important to realize that social ties also limit freedom, choice and autonomy. In Émile Durkheim’s study of suicide over a century ago, he argued that marriage, family and religion not only guard against the loneliness or “egoism” endemic to modern life, but also provide a salutary constraint of the imagination against the lack of rules, or “anomie,” that accompanies capitalism. Observing that the rates of clinical depression in the U.S. have tripled in the past quarter century of increased choice, Schwartz echoes Durkheim’s proposition that suicide rates are directly proportional to rates of egoism and anomie.

The book ends with a series of practical suggestions to help us cope with the bewildering array of choices contemporary life offers. Schwartz has clearly put his finger on a national mood, for the book is getting a great deal of coverage in the mass media. But Schwartz doesn’t want to leave the problem solely in the hands of individuals. Two days after President Bush’s 2004 State of the Union address, Schwartz published an op-ed piece in the New York Times, summarizing his book’s message in order to cast doubt on the president’s celebration of personal choice as public policy. Drawing attention to proposals for privatizing Social Security accounts for America’s workers, health insurance for seniors and school choice for children, Schwartz questioned the wisdom of “throwing an ever-greater menu of options at the American people.”

The psychology of social comparison and regret will affect workers as they decide how to invest their personal share of their Social Security taxes. It is not hard to imagine the privatized misery, the self-blame, of those whose choices turn out to be less than perfect. A lower, more porous social safety net means that some will be objectively better off, some will be objectively worse off, nearly everyone will feel subjectively worse off, and very few will have any reason to feel that their fate is shared. The safest prediction is that the biggest beneficiaries of Social Security privatization will be managers of the conservative mutual funds in which the vast majority of workers will invest in the hope that they will be no worse off than under the old system.

I had a chance to speak with Schwartz about the political and religious implications of his book. Did I have him right? Why hadn’t he been more explicit? He suggested that I would find some of the answers to my questions in his 1994 book, The Costs of Living: How Market Freedom Erodes the Best Things in Life (Norton, 1994; reissued 2001 by Xlibris). The earlier book is indeed more explicit. It is a full-scale, frontal attack on the application of market theory to social institutions. It argues that schooling, medicine and even baseball are debased when they are understood in terms of profit-making. It concludes with fighting words: “Economic imperialism must be stopped.”

But another thing stood out about The Costs of Living. It was not nearly as widely read as The Paradox of Choice. When I asked him about this, Schwartz acknowledged that this time he had hit a nerve. Less than six months after publication, his newer work is being translated into seven languages. Its author has received countless “heartfelt, thoughtful communications from people identifying their version of the problem.” He has been invited to consult with the office of British Prime Minister Tony Blair, the Department of Agriculture and Consumer Reports, as well as with software designers who suspect that the abundant options they offer may constitute an abdication of their responsibility.

But he insisted that the basic message has not changed. “If I were to rewrite The Costs of Living, I’d put everything in italics.” What is new is the more personal approach, beginning with the story about buying blue jeans that opens the book. The Paradox of Choice “is focused at a level where people normally think: ‘What can I do?’ ‘What’s going on in my life?’ And all the issues are more acutely true than they were a decade ago. . . . There are a lot of people walking around, really, really dissatisfied with their lives, unable to put their fingers on what it is that’s so troublesome. And because this notion of choice is sacrosanct in this society, that would be the last place they looked. . . . So I come out and I say, ‘Listen! This thing that we worship, maybe it’s not an unalloyed good.’”

It is also the case that his thinking resonates with religion. A chapter in The Costs of Living tells how he helped found a liberal synagogue. But he insisted that he did this not for religious reasons but because of his convictions, grounded in psychology and philosophy, that we need more constraint and less choice in our lives. “My convictions led me to embrace religious institutions. . . . I’m an atheist who cofounded a Jewish congregation.” Yet he also insists that salutary constraint cannot be arbitrarily imposed, and he cheerfully acknowledged that it was a nonarbitrary fact that any religious institution he might embrace would be Jewish.

Schwartz has convinced me that while we can’t be fully human without the capacity to exercise choice, we have better things to do than ponder alternatives. In the case of my illness, the prescribed first round of radiation and chemotherapy did its job of making the eventual surgery effective. Then there was the second round of chemotherapy required for insurance, and CT scans at three-month intervals ever since. We gladly agreed with the short interval despite the health risks posed by CT scans. What I may suffer in excess radiation is worth the lessened anxiety in the face of possible recurrence. Meanwhile, by the grace of God, life went on during the months of treatment and recovery, although at a slower pace. I read, wrote in my diary, taught some classes, served on committees, went to church, tried to sing and to swim, and spent time with my grandchildren. Sixteen months ago, the medical oncologist declared my cancer to be “in full remission,” and the pace of life quickened. “Sometimes,” says Schwartz, “satisficers get lucky.”