Analysis of images

Goldman (a sociologist) and Montagne (a pharmacist) have analysed the images used in advertisements for antidepressants LudiomilÒ (the image of a rose) and DesyrelÒ (the image of an eclipse of the sun) as follows:

"Advertisers have adopted the use of highly abstract visual metaphors and symbols in addressing physicians about antidepressant drugs. Campaigns built around an abstract visual aesthetics are designed to generate cognitive connections between named drug entities and the meaning of abstract visual images: these connections are called "carry-over symbols"...

In 1977 a benodiazdpine called lorazepam was marketed under the brand name AtivanÒ. Slick ads promoted ‘The Ativan Experience’ in full-page photograph featuring an intense halo of sunlight ringing a craggy mountain peak. Viewers found the scene connoted serenity, tranquility, rebirth, religiosity. The subject proclaimed, "Now it (‘the Ativan Experience' ) can be yours" via ingestion of these chemicals. The 'Ativan Experience' seemed to refer to a secularised salvation derived from the good works of corporate medical science. In glorifying the drug's effects, the ad infringed too closely on meanings of religious salvation: it seemed to extoll the experience as an end in itself (a practice normally legally prohibited in our society) and thus registered an ambiguous statement about inappropriate drug taking....

The AtivanÒ campaign illustrated a method of layout design which encourages readers to infer connections between multiple meaning systems. A similar advertising format is used in conjunction with abstracted photographic images to market consumer goods such as cosmetics, jeans, alcoholic drinks and cigarettes. Advertisers turn abstract pictorial representations into metaphors for a feeling or experience that may be associated with the product in question. Here the advertising format permits the abstract image to be renamed by the given drug, and thus transformed into a symbolization of the drug’s action...

This form of advertising produces, as a social side-effect, a reified [converted to an object] and medicalized account of psychiatric illness. Structuring ads to yield ‘carry-over symbols’ entails steering readers to perform reifying interpretive procedures. Actualizing ‘carry-over symbols’ depends on readers’ capacity and willingness to execute preferred interpretive moves encoded by the advertiser. Embedded in the performance of these routinized interpretive procedures are meanings and background assumptions which "legitimate and perpetuate certain views of doctoring, drugs, and patients that are commercially advantageous to the drug industry". Competition for control of market shares has escalated reliance on a communication form that abbreviates and truncates meaning systems in order to produce signs (carry-over symbols) which stand for drug actions and patients symptoms in relation to the unspoken role of the physician...

Within the medical profession, the issue of drug product advertising has stimulated a literature which addresses its functional, social and ethical impact on physicians’ attitudes and practices. Concerns in this literature include whether these ads disseminate spurious, inaccurate, and incomplete information about drug entities – a concern amplified by how these ads tacitly fulfill an educational function in the procession; that appeals are too frequently non-rational or symbolic; that images and content in these ads frequently build on, and perpetuate, social/sexual stereotypes. While health professionals have focused on advertising’s effect on prescribing, there has also been a residual awareness that a more significant and long-term sociological impact of these ads may be on modes of diagnosis...

Advertisers of psychotropic drugs repeatedly prefer binary oppositions as a way to conveying the meaning of depression and mental health.

….darkness (depression) is counterposed in lightness(non-depression).

Though the carry-over symbols for LudiomilÒ (rose) and DesyrelÒ (eclipse) differ, each endorses the metaphoric opposition to darkness and light. The DesyrelÒ ads extend the visual metaphor into verbal puns as a method of merging meaning systems: (a) "avoid many side effects that can often overshadow antidepressant therapy", (b) "…an antidepressant shouldn’t come between your patient and the light of productive and effective therapy:

Mead Johnson began marketing DesyrelÒ . DesyrelÒ was an immediate competitor product marketed on the basis of a recurrent symbol. DesyrelÒ ads used images of a solar eclipse to produce their recurrent symbol and also included a ‘carry-over’ theme – ‘a new light’-which was linked to the symbol. The pre-introductory ads appeared prior to FDA approval of trazodone. The first ad alerted professionals to Mead Johnson’s forthcoming venture into the field of psychopharmacological medications, and legitimated Mead Johnson as a reliable institution. An old-fashioned image evoked notions of medical history in which the solitary scientist/physician labors towards a glowing discovery of a cure. In the text a ‘new light’ refers to the idea of discover, which ‘from a trusted source’ reaffirms the integrity and continuity of Mead Johnson’s motives.

The first ad appeared in 1980 and ran for 6 months:

A third ad featuring an image of a total eclipse was published in March 1982 (Fig. 3). Since FDA approval had been received, the product was named in this ad, and "A new light from a trusted source" identified as DesyrelÒ . Here, in the moment of greatest darkness (the full eclipse) comes the promise of new light ("Watch for the light"). This introductory ad was a ‘tease’ which offered no solid information about the drug (though it says what the drug is not – a tricyclic or a tetracyclic). The ad, did however, encapsulate and portend the entire symbolic narrative spelled out in the campaign’s subsequent ads. A symbolic equivalence is drawn between the meaning of DesyrelÒ and the meaning of the sun. DesyrelÒ is made to stand for the sun’s illumination, while the sun is made to signify the healthy light of DesyrelÒ . The moon (lunacy, evil) blocks the sun, producing an eclipse (darkness, depression). But the ‘new light’ of the sun. DesyrelÒ lifts the veil of darkness and banishes depression.

The principal objective of the marketing strategy used for antidepressants such as LudiomilÒ and DesyrelÒ is to establish an associative connection between the product brand name and a visual symbol. With LudiomilÒ , the advertising goal is to fix in physicians; minds a correlation identity between the meaning of LudiomilÒ and the meaning of the rose so that the latter stands for the drug’s curative powers. From the campaign’s inception, the rose stands in metaphoric contrast to metaphors of bleakness and dryness. Casting the rose as a correlative for LudiomilÒ endows it with the meaning of LudiomilÒ as an antidepressant drug, and thus permits it to stand independently as a sign that signals LudiomilÒ as an appropriate treatmnt for depression. This is how the rose becomes a carry-over symbol for LudiomilÒ . Indeed, the manifest goal of the marketing campaign is that sign of the ‘the rose’ will remind physcians of LudiomilÒ . Hence, an additional aspect of the marketing strategy includes provision of other promotional materials with the rose image imprinted on them.

Abstract visuals are themselves the hook in these ads-a means of securing the interpretive participation of otherwise recalcitrant readers.

Reification

The question of the causes, origins or reasons for any particular person’s depression is rendered invisible and inconsequential. This practice of abstraction is congruent with the way medical practitioners become inclined to treat clients in a routinized fashion as categories. Relationships between doctors and patients are not merely technical, but also social interactions which draw on, and reinforce, dominant cultural premises. Patients enter anxious and dependent, their everyday life disrupted by the presence of symptons, and doctors recast their understanding of this reality. In our society, physicians' concentration on symptoms en route to assigning them to a ‘disease’ category, denies the human relations embodied therein.

Reviewing psychotropic drug advertising, Stimson observed that similar ads encouraged 'at-a-glance of diagnosis’ a form of diagnosis which corresponds to the way physicians read the ads themselves. Emphasis on an ideology or mystique of the healing powers of pharmaceutical technology; (a) encourages routine use of chemical substances to deal with the experience of depression as if there existed an automatic relationship between ingestion and cure, (b) encourages physicians to discount personal histories of patients, although individual variation is important both physiologically and psychologically. Physiologically, individual metabolism varies widely. Depending on the patient's particular medical history, the new drug entities, maprotiline and trazodone, may be helpful or harmful. Psychologically, patient attitude is an important consideration not only in drug selection, but also in determining whether chemical substances offer a therapeutically effective approach at all. Patients develop feelings about prior experiences with antidepressants, and these feelings become a factor in subsequent usage of drug therapy.

These ads reflect a positivist conceptualization of mental illness and doctoring as mind mechanics. It seems ironic these 'objective' explanations would be set forth via a communication format which demands highly subjective interpretations of abstracted images

The LudiomilÒ campaign presented the rose's image in various phenomenal forms. On occasion, only the flowering part was shown, while at other times, a long-stemmed version appeared. The rose was depicted photographically and in line-sketch form, with and without dew drops, in vivid red, and black and white. But never did the rose have thorns. Purging the presence of thorns from the rose's image, the advertiser conceals the nature of contradiction. Because advertisers have vested interests in presenting unified, but one-sided accounts, they tend to arrest the dialectical relations which take place in the real world. In the LudiomilÒ campaign, where the agenda has been to establish a carry-over sign linked to the product, the advertiser drew on a complex cultural symbol-the rose-for the purpose of transforming it into a linear, binary sign. The transposition of a symbol into sign reflects a crucial cultural logic set in motion by the sales apparatus-namely the commodification of meaning. In the classical symbolism of the rose, the thorns give irony to the flower's beauty. But the advertising transmutation of the rose's image into a sign value involves masking elements of internal contradiction (negation is banished within the confines of the ad page), so that the rose as sign functions like a traffic signal: when it is present, think 'Ludiomil for your patient'.

These ads reductionistically deny not only the sociocultural roots of depression, but also its institutional basis, opting instead for a mechanistic view of depression as an individuated chemical balance sheet gone awry. Because there is no mention of the unique configuration of factors that may produce depression in any given individual, these pharmaceutical company-sponsored accounts of depress over the complexities of residing in actual life-worlds."
- Goldman and Montagne (1986)

Goldman R, Montagne M. Marketing "Mind mechanics": Decoding antidepressant drug advertisements. Soc Sci Med 1986;22(10):1047-58