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Ads, ads everywhere, but not one to click
Sarah Lawrence for Vox

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When targeted ads feel a little too targeted

How do you outrun something that’s designed to follow you everywhere?

It wasn’t long after her mom died of cancer in March 2014 that targeted advertisements turned Lindsay Robertson’s version of the internet into a virtual graveyard. “It was just gravestones everywhere,” she says. “It was crazy. It was every type of gray, typical headstone covering all the available space.”

Robertson, the oldest of four, became in charge of certain end-of-life arrangements. She didn’t know how much headstones cost — so she googled it. This simple search likely triggered certain trackers that knew Robertson was looking for headstones, and then used that information to send targeted advertisements to her that then followed her around the internet.

The files used to track individuals — called cookies — are there to help keep the internet functioning. It’s cookies that keep you logged in to certain websites, or keep your shopping cart filled while you browse. Cookies can also tell advertisers what products or websites you’ve interacted with, allowing companies to advertise that product or similar products to you in a process called remarketing. Advertisers can set a time limit and a cap on how many ads someone can see and for how long — though these settings don’t always work perfectly and not everyone sets them.

Third-party data providers can also use what they’ve seen about what you’re interested in and have interacted with online — or your age, location, gender, or other details — to create audience lists that advertisers use to find a market for their ads. These lists can become very specific and often overlap with each other, and how people get on and off the lists is not always clear — even to advertisers. Companies like Google and Facebook have collected a lot of data about individuals over the years to make these lists, and other third-party data providers have their own lists and methods for creating them. Advertisers select lists to send their ads to, and cookies can allow advertisements to follow an individual from website to website, or app to app.

When someone has experienced a trauma or is struggling with something — and is perhaps searching for answers online — these ads can become an unwelcome reminder. The best many can hope for is that these ads are unnoticeable or mildly annoying. For others, though, they can cause real harm to mental health.

Facebook has some rules that may stem some of the damage that could come from certain targeted ads. For example, Facebook’s policy is that ads can’t target people based on their medical history, or make implications about a person’s medical condition. They also can’t include unlikely before-and-after images or other content that tries to generate negative self-worth to promote diet or health-related products.

Unfortunately, these and other companies’ policies don’t prevent harm entirely. For me, stress from targeted advertising started when I got off hormonal birth control in the hopes of one day trying to get pregnant. Getting off birth control was a nightmare — my cycle took months to regulate and I didn’t know if something was wrong that could possibly keep me from having kids. So I did a lot of searching on the internet for problems related to irregular periods and fertility. I’ve since gotten reassurance and tests from my doctors, but in the meantime, I started getting ads for period products, and they haven’t stopped. These ads may not have been based on my actual medical condition, but they sure made me worry about it.

Every tampon, period panty, menstrual cup, and pad advertisement was just another reminder of the very thing I feared, all day, every day. There was no escaping my worries, especially when those worries seemed to follow me around virtually everywhere I went.

I’m not the only woman aged 25-35 whose vision is flooded with ads related to fertility, periods, or babies. “It seemed like the day I turned 25 I got absolutely spammed with ovulation and pregnancy test adverts,” 34-year-old Molly Bradshaw tells me in an email. “I stopped going on YouTube because even after going to my YouTube adverts options section and blocking the specific adverts, I couldn’t escape them.” Bradshaw, who lives in the UK, was diagnosed with premature ovarian failure after her ovaries shut down at 29, and will never have biological children. She says that she still gets served pregnancy-related advertisements online at age 34, but now she also gets advertisements related to menopause. “I find it deeply upsetting,” she says.

Advertisements work by making the consumer desire something they don’t have so that they buy it. But when ads remind a person of something that they can’t have, it can be painful. You can’t go to the store to purchase a baby, or a functioning uterus. You can’t buy relief from grief on Amazon.

As people’s behavior shifted with the onset of the coronavirus pandemic over the last few weeks, the ads some see have shifted as well. Alcohol delivery ads, sweatsuit ads, home gym ads, and others are showing up more often in some feeds. For Rachel Kaufman, office supply store ads for toilet paper and hand sanitizer have started appearing. “I’ve never gotten those ads prior to like a month ago,” she wrote in a Facebook comment. She tells me in a message that the ads themselves aren’t causing additional stress, but she’s been clicking on them out of the hope those items will be in stock so she can help provide for her family.

“I have older parents who were out of the country until last week and an asthmatic brother with special needs, so I’m doing my best to make sure everyone has the basics they need. So when I see ads I get excited,” she says. “Everything is sold out. Every time. And that just leaves me a bit more deflated than before.” Because she’s clicking on these ads, it’s likely that she’ll see more of them, creating a cycle of hope and disappointment in an already stressful time. “It’s predatory,” she says.

Unlike who you follow on social media, what ads show up on your feed are harder to control. There are ad blockers or steps an individual can take to try to minimize their exposure to certain types of ads — but the lack of clarity around how and why they appear can cause confusion about what steps to take. Besides, navigating how to block advertising creates additional work for the traumatized, who may already be struggling.

Targeted advertising can be a particularly brutal reminder of trauma because the ads feel so personal and individualized, and because what you search for or browse online can affect the ads you see, creating a feedback loop of pain. Gillian Brockell wrote for the Washington Post about seeing pregnancy-related ads even after her child was stillborn. These ads reflected what life was like before her child died because of what she had searched and interacted with online for months as she prepared for a baby. It seems impossible that these trackers can learn so much about you, but not know the one thing that causes particular ads to be so painful. “If your algorithms are smart enough to realize that I was pregnant, or that I’ve given birth, then surely they can be smart enough to realize that my baby died, and advertise to me accordingly — or maybe, just maybe, not at all,” Brockell wrote.

When what you’re searching for online has to do with past trauma or something you’re not ready to share, ads related to those topics can feel not only harmful to your mental health, they can also be revealing. For a person exploring their sexuality or gender, for instance, ads on an app or computer screen may give away what an individual searches in private.

“When you’re in a space where you are still potentially having to not be who you are — you’re still ‘closeted’ — the unexpected reminder can feel destabilizing,” says Tia Dole, the Chief Clinical Operations Officer at the Trevor Project, a suicide prevention organization for LGBTQ youth. Dole says that targeted ads can also put people at risk if, for instance, a young person shares a computer with a family that doesn’t accept their gender or sexuality, and ads related to their internet searches pop up. Furthermore, worrying that what you’re searching for will show up in unexpected ways later can add to the mental strain.

If the ads remind you of something that you’d rather be secret, that can also add to feelings of shame. Columbia Business School professor Michael Slepian, who has researched how keeping secrets affects people, found that what is actually most harmful about secrets is ruminating on them alone — not necessarily the action of hiding something. “So if something on a website reminds you of your secret, that’s exactly the situation where we know secrets harm us the most,” he says.

Maria Rago, board president of the National Association of Anorexia Nervosa and Associated Disorders, says that for people who have an eating disorder, “they could either go down the path to recovery, or they could go down the path to get sicker or stay sick.” The media that someone consumes can affect recovery, possibly tempting unhealthy ways of thinking. If someone with an eating disorder researches diets, for instance, then meal supplements or diet ads may appear for them. Bonnie Brennan, regional clinical director of the Eating Recovery Center in Denver, Colorado, says these dangerous reminders or images don’t just come from targeted advertising, they can come from anywhere in everyday life. Even for people who have strong recoveries, Brennan says, it can be hard to look away when they get sucked into something that reminds them of their eating disorder.

I’ve been getting ads for hand soaps over the past few weeks, and it feels impossible to know if that’s because I’ve been searching for facts about hand-washing amid worries of Covid-19, or if everyone else is also seeing the same ads I am. My husband says he hasn’t noticed any, so it makes me think that it’s because of my internet browsing. Or perhaps it’s because many advertisers seem to think women do the washing and the shopping, even though in my home we split domestic duties so that my husband shops for groceries. Sara Wachter-Boettcher wrote in her book Technically Wrong that these kinds of sexist and racist assumptions can become more deeply embedded when tech companies use proxy data — like the pieces of data that cookies use to track people. No matter the reason these ads were there, seeing ads about hand-washing adds to my cycle of worrying and wondering who’s watching what online.

Targeted ads can echo and reinforce what you worry about and search for at 3 am when you can’t sleep. Watching my worries get sold back to me as I tried to figure out what might be wrong with my own body felt stomach-churning. Because I was worried about having kids, which is the subject of many ads for people in my demographic, every ad was also a reminder of how I might not fit into that demographic anymore.

That’s a big problem with some of these targeted ads. They feel like they should be personalized to an individual, but they also advertise conventional things like marriage, having children, and owning a home. If someone doesn’t fit into those conventions, these advertisements can reinforce just how much they’re excluded, which can be baffling when the ads are so specific to a person but miss these larger points about their lives. Jordan Woodruff is the administrator of a generalized anxiety disorder support group on Facebook, and he says that among this group, a lot of the depression and anxiety people feel about targeted ads comes from subjects like weddings, children, and babies.

Seeing these ads feels like being caught in an uncanny valley where the robot can’t quite cross over into realistic human compassion or understanding. “Being constantly reminded that I was forever excluded from such a huge element of mainstream existence? Yeah, that stung a bit,” says Kalvitis. “Who needs ‘mean girls’ when you have tiny robots?”

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