CHAPTER 5
Diagnose the Pain

A circle with text at the bottom, “DIAGNOSE THE PAINTM” with an iceberg along the water with text, “LIKE”, “WANT”, “NEED”, “PAIN”, and “FEAR” (top–bottom).

“Most people want to avoid pain, and discipline is usually painful”.

– John C. Maxwell Clergyman

WHY PAINS DRIVE BUYING BEHAVIOR

First, your message must target the elimination of fears, threats, or risks that the primal brain prioritizes to eliminate. As humans, we aspire to reduce or remove anxiety to survive and to feel safe. As we learned in the section on personal, our brain has evolved over millions of years. Even today, we need to pay attention to events that matter most to our survival so that we can thrive as a species. According to Stanislas Dehaene, a foremost expert on the neuroscience of consciousness, our ability to navigate a complex array of decisions is driven by the level of vigilance we apply to critical states of consciousness. As vigilance rises (as threats increase), the brain recruits more brain areas in a bottom‐up process that results in recruiting more cerebral blood flow [136].

Since vigilance is so critical to how brain energy radiates from emotional to cognitive layers (from subconscious to more conscious), it is why we are anxious beings, not only when we wake up every day, but also when we make buying decisions. It is part of our default processing mode. Our brain is like a car that is always in an idle “anxiety” state. Vigilance is the basic program that helps us cope with this idle state. Starting the engine is not an option when you need to drive away quickly! Our state of vigilance is central to our capacity to face the challenges life throws at us. Sigmund Freud famously suggested that human anxiety was responsible for most mental disorders. For Freud, anxiety came from worrying about the future, without having a very precise idea of what could cause harm. The top expert on fear and anxiety in the neuroscientific community, Joseph Ledoux, supports this view [137]. Ledoux insists that there is a critical difference between anxiety and fear, in that anxiety is mostly produced by subcortical brain areas of the primal brain and typically does not involve or require the conscious, more rational, and more recent layers of our cognitive machinery. He reminds us that the root of the word anxiety is the Latin word anxietas that itself comes from the Greek word angh, which was used to describe unpleasant physical sensations like tightness or discomfort.

In fact, today anxiety disorders affect more than 20% of the US population. Many of the people who suffer from anxiety‐related diseases cannot naturally cope with the psychological and sometimes physical impact of the ongoing rumination of their worries. I am not suggesting that buying a product may produce as much anxiety as experiencing the dread of not being able to afford a house, find a job, or break a cycle of bad relationships. I am, however, claiming that anxiety is generated largely by the dominance of our primal brain. As a result, we tend to use the same neural networks to assess the relevance and value of a purchase as those we use to cope with a life‐threatening situation.

The iceberg in Figure 5.1 helps you recognize the hierarchy of decision drivers that influence how and why we buy. For instance, the motivation that directly influences a buyer's brain often arises from fearing devastating consequences, such as the fear of regret or the fear of disappointment. Fear causes frustrations or pains, which ultimately affect what we say we need, want, or even like. Note that many of our worries and fears may be completely unconscious, while we can typically articulate what frustrates us (pains), what we need, want, and like.

Illustration displaying an iceberg along the water with text, “LIKE”, “WANT”, “NEED”, “PAIN”, “FEAR”, and “ANXIETY” (top–bottom, small font–large font) having 2 vertical bars located at the left and right sides.

Figure 5.1 Iceberg of decision drivers.

The iceberg of decision drivers is a powerful metaphor to explain how critical psychological and neurophysiological states affect our response to persuasive stimuli. Traditionally, marketing research has focused on what people say they like or think they want. However, neuromarketing studies have now proven that customers cannot be trusted to articulate or even confirm what they like or want. That is why both likes and wants are poor predictors of buying behavior. Likes and wants are vague conscious interpretations of what we think we need to be happy and safe. They tend to shift over short periods based on lifestyle changes, trends, and even moods. On the other hand, our core fears and pains are more permanent. As such, they become the best predictors of how people make decisions.

Since we formed SalesBrain nearly 20 years ago, we have designed numerous surveys, conducted hundreds of focus groups, and facilitated thousands of in‐depth interviews. We have collected self‐reported feedback from thousands of people from over 10 countries. Collecting data on what people want systematically yields confusing if not misleading insights. What we have learned over nearly two decades of neuromarketing research is that nothing is more powerful than asking people what they fear. What they fear comes from our human nature of being anxious and vigilant to survive.

The Nature of Fear

According to Ledoux, fear is associated with emotional events for which we can identify a specific threat. The semantic difference between both terms may appear pointless until you realize that anxiety is more diffuse and more permanent than fear, while fear is more precise and typically more imminent than anxiety. Ledoux argues: “To experience fear is to know that YOU are in a dangerous situation, and to experience anxiety is to worry about whether future threats may harm YOU” [137].

The Nature of Pains

We understand that in most cases, it is very difficult if not awkward, to discuss anxiety and fears with your customers directly. When we conduct a neuromarketing experiment, we can assess the level of arousal and fear that people may experience watching an ad without requiring conscious feedback. However, for many of SalesBrain's clients, identifying the neurophysiological basis of fears associated with the purchase of a product or a solution is both costly and challenging to execute. On the other hand, engaging in PAIN dialogues that can specifically focus on what people consider their biggest frustrations associated with the purchase of a solution is relatively easy to do.

Diagnosing the top pains is a critical step because it will later help you select a few benefits of your value proposition that can directly eliminate the top sources of frustrations. It is like putting the dozens of reasons why customers should buy from you through a strainer. Only those that offer a direct, unique, and credible solution to the top pains should stay in the strainer!

Often, pains are simply correlated to complaints, pet peeves, or grievances that customers have once they have purchased or used a product or a solution. When you sell something new, pains can predict future complaints. Here is some valuable data to help you further understand the power of diagnosing the top pains to increase customer satisfaction [138].

  • Sixty‐six percent of customers switch to another brand because of receiving poor service.
  • Fifty‐eight percent will never use a company again after they experience a negative experience.
  • Forty‐eight percent of customers with negative experiences will tell ten people or more, whereas good experiences are shared with five or fewer.

These data points stress something obvious: we are more affected by negative customer experiences events than we are by positive ones. This is why we tend to spend more time sharing our customer nightmares than we do sharing our pleasant experiences.

The Nature of Needs

Psychologists investigating how personality traits explain and predict our behavior popularized the term needs. Needs typically describe what we seek to acquire or do to protect and enhance our lives. The field of personality studies has debated for decades the psychological (and most recently, the neurophysiological) basis of our needs or, more simply, what drives us on a day‐to‐day basis. For our discussion, though, let's review one of the most important models explaining the importance and usefulness of having needs: the Maslow Theory [139].

The Maslow Theory. Abraham Maslow [140] had a rather optimistic view of human nature. He believed that Freud had identified “the sick half of psychology” (p. 5) and suggested that his own model would provide “the healthy half” (p. 5). His view of motivation was dualistic. He believed we have two types of motives: deficiency motives and growth motives. Deficiency motives are common to all people and address physiological and emotional needs such as hunger, safety, love, and esteem from others. Growth motives are specific to some individuals and explain the unselfish pursuit of knowledge or love we can provide to others. He proposed that humans must, in fact, satisfy some basic needs before they satisfy higher needs like self‐actualization. His famous ladder of human needs (Figure 5.2), known as “Maslow's hierarchy of needs,” shows physiological needs at the bottom, followed by safety needs, belongingness and love needs, esteem needs, and self‐actualization.

Maslow hierarchy of needs depicted by a triangle with 5 segments labeled self-actualization needs, esteem needs, love needs, safety needs, and physiological needs (top–bottom).

Figure 5.2 The Maslow hierarchy of needs.

Moreover, Maslow believed that human needs vary with age and map our personal development stages as illustrated by the graph in Figure 5.3.

Graph of Maslow’s needs with different shaded areas labeled Physiological, Safety, Love, Esteem, and Self-actualization.

Figure 5.3 Timeline of Maslow's needs.

Clearly, the primal brain is implicated in the pursuit of the first three needs of the pyramid, whereas the last two require more influence from the rational brain. At a deeper level, though, the theory of needs proposed by Maslow is a theory of human motivation. To that extent, because buying a product or solution requires motivation, Maslow's model is both relevant and important to understand. However, the model does not integrate the complex routine of neural processes that trigger the expression of all basic needs. Additionally, the model posits that human development follows a well‐planned progression of sequential and logical psychological stages, as if they were like rungs on a ladder. Obviously, this is simplistic and is no longer supported by today's understanding of developmental psychology. To conclude, asking consumers what they need is not enough to predict their behavior. This is why marketers have relied on measuring another decision driver to understand consumer behavior: the nature of our wants.

The Nature of Wants

The nature of our wants points directly to the consumerism movement and the well‐accepted idea that our wants are insatiable. There is, again, a subtle difference between needs and wants. Wants articulate desires that can go beyond what we would consider basic needs. Most researchers on the subject argue that wants are outcomes that make us more influential or more powerful, like money, power, or public attention [141]. Frankly, the theoretical discussion on the subject has been blurry for decades because it has relied for too long on what people are willing to say they want. Fortunately, recent studies coming from the field of neuromarketing and neuroeconomics have provided a more credible theoretical framework to understand our wants.

In his book Introduction to Consumer Neuroscience, Thomas Ramsoy presents his theory for the neurophysiological basis of our wants. He claims that “wanting” is mediated by a brain structure called the nucleus accumbens (NAcc), a brain structure we have discussed several times already in this book when we discussed the emotional stimulus. It is tucked deep in the primal brain. Ramzoy suggests that “wanting is the unconscious approach and avoidance evaluation related to items, organisms, and events.” He uses a well‐known study from Knutson and colleagues to support his theory [41]. We already cited this source, but to remind you, Knutson claimed that he could predict what people “want” before they decide by looking at the surge of blood flow to their nucleus accumbens. Unfortunately, although we have a better understanding of which areas of the brain predict the want signal, there is still no reliable scale to collect people's self‐reported evaluation of what they want. In other words, unless you put people in a fMRI, your ability to measure what people want is very difficult and mostly unreliable. This is why we suggest that collecting pain data is easier and more predictive of purchasing behavior.

The Nature of Likes

The concept of liking may be less ambiguous than the concept of want. After all, we can usually report whether we like something or not. Liking is typically captured by asking people to rate something, which is a way of providing a grade or a numerical assessment of how much you enjoyed a product or an experience. As such, you would think that measures that come from liking or rating are more reliable than measures of what we want. Think again! A famous study conducted by Gregory Berns on the popularity of songs revealed that the liking data was not predictive of the neural response [142]. For instance, the data collected from the nucleus accumbens activity, which also correlates with what people choose (or buy), did not correlate with the liking data. Even Facebook considered the importance of going beyond collecting like data by adding emoticons a few years ago. This provides the social media company more emotional granularity that their data scientists can use to analyze the sentiment expressed by millions of users.

AN INTEGRATED VIEW OF DECISION DRIVERS

The process of how consumers assess, respond, and eventually decide after they are exposed to persuasive messages is complex and the source of extensive debate among scholars and researchers. Our proposal for an integrated view of decision drivers considers neurophysiological research and traditional research performed on a wide range of products and industries, as well as over 20 countries. We believe that decisions are influenced by the dominance of the primal brain and especially the pains we strive to eliminate.

Buyers typically start their journey in a basic state of ignorance or anxiety about a product or solution, a situation in which risk is potentially high (the fear of regret), and the cognitive involvement is typically low. However, to the extent that a product or solution is made relevant, urgent, and useful by re‐awakening pains, specific fears become activated. For instance, if a message is making you realize that you could die abruptly and leave your loved ones with massive debt by not having life insurance, you face multiple fears you feel you need to address quickly. By considering the value of having life insurance, you now move from a neutral state to a state of interest. Two possibilities happen next. If you are not willing to engage cognitively with the topic, you will choose to forego a decision, which means do nothing or else evaluate another option. However, if the message or the value proposition is successful at activating cognitive engagement, you will move to a “want” state and feel the motivation to buy (anticipation), rewarded by a nice dose of dopamine in your brain. So, as you can see, diagnosing pain is a central construct persuasion step that increases the likelihood you can create effective messages. Know the pains you need to eliminate, and you have the script of your best selling arguments!

Indentifying the Top Pains

We have conducted thousands of surveys and interviews of which the sole purpose was to unveil customers' top pains. Although the products and services for which we did these interviews vary greatly, from fMRI equipment to cosmetic products, we have consistently been able to categorize pain insights in three categories.

The Three Sources of Pain. Pain always falls into three main categories: financial, strategic, or personal.

  1. Financial pain pertains to economic factors such as the loss of revenue, low profitability, or bad ROI. Financial pain is typically highly visible and easy to measure.
  2. Strategic pain includes issues that affect key business risks that can compromise the development, manufacturing, marketing, or delivery of products and services. Typical types of strategic pains are poor product quality, production inefficiencies, high customer complaints, and poor brand recognition. Strategic pain is not always as visible as financial pain and cannot always be easily measured.
  3. Personal pain is made up of the negative feelings and emotions affecting those who are involved in the buying decisions. Examples include elevated levels of stress, job insecurity, or working longer hours.

Table 5.1 should help you quickly understand how to recognize and label the pains you can diagnose.

Table 5.1 Pain types.

Source of the Pain Areas of Pain and Frustration Methods of Pain Measurement Fear/Pain Affecting the Primal Brain
Financial
  • Lack of funds
  • Low return on investment
  • Data
  • Stories
  • Fear of not having enough
  • Fear of losing what we have
Strategic
  • Quality issues
  • Long delivery delays
  • Long product development cycles
  • Market benchmarks
  • Mappings
  • Surveys
  • Competitive analysis
  • Fear of not knowing enough
  • Fear of not having control
Personal
  • Poor attitudes
  • High stress
  • Lack of motivation
  • Employee surveys
  • Leadership assessments
  • Neurophysiological studies
  • Fear of powerlessness
  • Fear of worthlessness
  • Fear of extinction

Conducting Pain Dialogues

There is an effective way to identify the most critical pains. Just create an intimate dialogue with your top customers. Customers, not prospects, are the best source for this crucial information. Customers have had the benefit of an intimate relationship with your value proposition already, so they can share a unique perspective on what transformation it brought to their lives by your solution. Simply ask them the following questions and be prepared to practice deep listening!

  1. What were some of the top challenges, hurdles, or risks you were facing before you found our solution?
  2. How much money would you lose by not using our product?
  3. How did our product help you eliminate risk or uncertainty? Describe a typical situation where you felt you did not have enough control because you did not have our solution.
  4. How did our solution make you feel better about yourself, your job, or your family?

You can adapt these questions to match your situation, but as you can imagine, only a few discussion points can reveal critical areas of pains and frustrations that are at the core of why people will choose your solution. Note that if you are selling a product through resellers, you need to do this process twice, once for the end‐users and once for the resellers. To the extent that their areas of concerns vary, you will find that you need to change your message to stimulate the primal brains of each target group.

PAIN CASE STUDIES

It is quite remarkable how getting clarity on the top pains that your business or solution can eliminate may be the single most critical issue to solve to find the persuasion code of your messages. Let's consider these examples.

Domino's Pizza

The pizza delivery business seems straightforward and highly commoditized. You would think that to be successful in this activity; you need to focus on making a good pizza. However, very early on, Domino's didn't focus its main claim on the pizza. They focused on solving a critical pain: the anxiety of not knowing when the pizza will arrive (Figure 5.4).

Photos of a piece of pizza (left) and a right hand with a wrist watch pointed by an index finger having a domino at the bottom left labeled Domino’s Pizza (right).

Figure 5.4 Pizza pain.

This strategic decision is at the center of Domino's success, not just in the United States but outside as well. Today, Domino's Pizza is the first largest pizza restaurant chain in the world (Pizza Hut is the second!), with more than 14,400 locations in over 85 markets. They are like the Federal Express of the pizza industry: the pizza delivery experts! The pizza itself is important but it's not the key differentiator for Domino's Pizza.

For many years their slogan was: “30 minutes or less, or it's free.” Notice how it provides a perfect cure to the pain!

Starbucks

Meanwhile, you may think of Starbucks as the company that gives you the drinks you want. However, the success of their mission is because they realized that people spend most of their time at home and in the office. Yet people experience the pain of missing a transitional environment that helps them switch mentally from their home mode to their office model. The founder and former CEO of Starbucks, Mr. Schultz positioned the business as an ideal third place.

The “third place” is like a decompression chamber, the home away from home, the workplace away from the workplace (Figure 5.5). That positioning has made Starbucks unique and very successful in over 70 countries and over 24,000 locations because it solves a major pain for millions of people every day.

Left: photo of a coffee cup. Right: photo of a hand holding a key with a house key chain (top) and a hand holding a computer mouse (bottom). Between the 2 photos are 2 clockwise arrows with a Starbucks logo at the center.

Figure 5.5 Starbucks pain.

Photos of a taxi cab (left) and a woman, in business formal attire, standing and pointing her wrist with a suitcase and an UBER icon at the middle left area (right).

Figure 5.6 Uber pain.

Uber

Meanwhile, another company that did not even exist 10 years ago built an empire by targeting pains many of us share: going from one point to another quickly and cost‐effectively without owning a vehicle. How many of us have been frustrated waiting for a cab not knowing exactly when it would arrive? and have you not wondered when you would get to your destination and if you would have enough cash to pay for the ride (Figure 5.6)? Today, Uber operates in 84 countries, has over 160,000 drivers and holds a market value of $70 billion, while not owning one car.

For the preceding examples, winning market share was not just a function of offering products or solutions, but performing a good diagnosis of the underlying pains. Table 5.2 helps you appreciate the power of making a crucial distinction between marketing what customers want and marketing to their pains.

Table 5.2 Marketing to pains.

Wants Pizza Coffee Taxi
Pains Not knowing Not having an option between home and office Lack of control

Pain Cluster Studies

The process of diagnosing pains typically involves two steps:

  1. Qualitative exploration, achieved by conducting pain dialogues
  2. Quantitative measurements, done through telephone or online surveys

The best way to organize pain data is to perform a pain cluster analysis. The concept is challenging to understand from a mathematical standpoint, but the purpose of the technique is to classify survey respondents (sometimes called segments or clusters) that share common patterns of responses on pain questions that are most predictive of future purchasing behavior. At SalesBrain, we have performed hundreds of such studies and what we have found will not surprise you: pain questions are always the most powerful questions to create segments of customers that have common patterns of consumer behavior.

WHAT TO REMEMBER

  • Diagnosing pains helps you unveil the most critical decision drivers out of the many psychological factors that may influence your customer's behavior.
  • Humans aspire to eliminate worries to survive and thrive. Our nature is to orient our attention to messages that awaken our fears, which is why a product or solution that can clearly articulate which pains it can eliminate first will receive more consideration and create higher urgency.
  • There are three types of pains that can explain how and why people become attracted to a specific value proposition: financial pains, strategic pains, and personal pains. They all point to either material, emotional, and psychological needs we want to satisfy.
  • Once you have successfully diagnosed the top pains by conducting pain dialogues, quantify the importance of the pains as well as consider creating segments or clusters of your top customers who share common pains.

The following sections are written by Patrick Renvoisé, the cofounder of SalesBrain, the “other hemisphere” of the SalesBrain team. Before starting SalesBrain with me, Patrick traveled over three million miles around the world to sell sophisticated products and solutions for Silicon Graphics (SGI) and for Linuxcare. As a computer engineer, he is truly passionate about making the complex simple to understand and helping people communicate and deliver memorable messages.

In prior chapters, I helped you understand the why of neuromarketing: Why does it work? Why can we not trust what people say? Why do we need to use new methods to collect invaluable information to decode people's intentions? Why do we no longer have the option to ignore persuasion sciences? I also introduced the first step to prepare your persuasive message based on NeuroMap: Diagnose the pain.

Patrick will now cover the remaining three steps starting with Step 2:

  • Differentiate your claims: How to identify the top two or three unique reasons why people should choose your solution – or adopt your ideas – versus buying from your competitors or doing nothing.
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