As cultural-clinical psychologists, we are enthusiastic about Singh’s proposed psychological approach to how universals are selected and see applicability to our field. Healing traditions for psychological distress share universal features, such as fostering cognitive flexibility and centering the sufferer-healer relationship (Hinton & Kirmayer, Reference Hinton and Kirmayer2017; Wampold, Reference Wampold2015). Singh’s theory of super-attractors can help us think carefully about how such universal features emerge, pointing toward more specific mechanisms.

Healing practices for mental illness likely emerge from the tendency to socially signal distress. Singh convincingly describes some psychological mechanisms that shape selection of cultural-historical variants. It makes sense that a sufferer would select healing practices appraised as useful. His approach, however, gives insufficient attention to the reverse influence: how cultural-historical context shapes psychology. Evaluations of usefulness within a cultural context are not independent of said context. Healing practices are maintained by shared beliefs about causes of and effective interventions for distress (Chentsova-Dutton & Ryder, Reference Chentsova-Dutton and Ryder2020). Humans innovate – but also strongly rely on existing practices.

Singh’s account of subjective selection is well-suited to domains with concrete, easily observable, nonsocial outcomes, with clear cause-outcome relations. Yet, he describes socially embedded super-attractors with multi-determined outcomes and non-obvious links between cause and outcome. Many outcomes he discusses depend on expectancies and social norms; evaluations of these outcomes are themselves culturally shaped. In his example of mango picking, the mangos are unaware of expectancies and are not shaped by their history of watching other mangos being harvested. In contrast, babies listening to lullabies, participants in shamanic rituals – and sufferers consulting healers – are attuned to social context. Although lullabies may have universal benefits “in a cultural vacuum,” actual benefits are shaped by the infants’ learning histories and exposure to different calming techniques. Similarly, a milieu that supports a given healing practice shapes this practice’s effectiveness.

Psychological models of goal pursuit are evolving (some studies cited by Singh have failed to replicate). Recent models point to processes underlying selection and maintenance of super-attractors that are more complex than acknowledged in the target article. These approaches move beyond agentic cost-benefit models to models that highlight dynamic co-creation and co-maintenance of goal pursuit. Humans are sensitive to costs and benefits of their actions from an early age, but over time develop epistemic concern with maintaining a shared reality (Higgins, Reference Higgins2016). Accordingly, adults pursue goals for reasons that are not only instrumental but also socially normative (Ajzen & Kruglanski, Reference Ajzen and Kruglanski2019). Singing a lullaby that fails to soothe remains an opportunity to show oneself as a dedicated parent; participating in a treatment that fails to heal still reassures family and friends about one’s commitment to getting better.

Selection of goals, and ways to achieve these goals, depends on more than effectiveness beliefs and also involves goal commitment, relevant values, expectancies for the chosen strategy, and capacity to control the problem, all of which are dynamically modulated by prior experiences of goal pursuit (Ajzen & Kruglanski, Reference Ajzen and Kruglanski2019). Different behaviors allow people to meet the same goal (equifinality); the same behaviors can serve different goals (multifinality). Goals are pursued within ecologies of other – potentially conflicting – goals. Consider a potentially effective new healing practice introduced to a community by visitors from abroad. Some people might include this practice as they seek healing because of prior positive experiences with other cultural practices from the same origin; others might use it exclusively in order to show that they are modern; still others might reject it because they place a higher value on goals of maintaining tradition and resisting outside influence.

Like goal selection, usefulness in the service of subjective selection is not evaluated in a cultural vacuum and is partially shaped by one’s history with, and local beliefs about, a given practice. In interpersonal domains especially, effectiveness is not independent of what is culturally understood as effective; for example, is assertiveness or humility a better way to fulfill social goals? Healers build efficacy beliefs by delivering something objectively effective and also by capitalizing on joint expectations and the quality of the relationship. Effective healers share a common “illness myth,” a cultural model of illness and its treatment, with sufferers – one that includes beliefs about the healer’s effectiveness (Frank, Frank, & Wampold, Reference Frank, Frank and Wampold2025).

A sufferer participating in a healing practice for the first time likely has some familiarity with how it unfolds. Broad cultural assumptions inform the approach: belief in the power of spirits supports shamanic healing; belief in the power of emotional release supports many psychotherapies. Beyond perceptions of effectiveness, such beliefs are central to “actual” effectiveness. There is now considerable evidence that the placebo effect is better conceived as a “meaning effect,” reflecting the influence of effectiveness beliefs even at a biological level (Benedetti, Reference Benedetti2021; Moerman, Reference Moerman2002). Most contemporary psychotherapies are at least moderately effective, an observation explained by so-called “common factors,” such as rapport with the healer and the shared illness myth. A similar rationale may explain the effectiveness of traditional healing practices for at least some presentations of mental illness (Nortje et al., Reference Nortje, Oladeji, Gureje and Seedat2016). Certain interventions do offer additional advantages, but neither sufferers nor practitioners are well-attuned to this valuable cost-benefit information, raising further questions about the limitations of effectiveness evaluations (Lilienfeld et al., Reference Lilienfeld, Ritschel, Lynn, Cautin and Latzman2013).

From this vantage point, we find it hard to believe that people across a wide range of cultural-historical settings would continually make similar subjective judgments about effectiveness in domains with multi-determined outcomes. A more psychologically realistic account would propose that super-attractors emerge universally in part because they are evaluated as effective regardless of consensus, but also because they facilitate consensus that they are meaningful – and hence, effective. Selection of super-attractors is not purely subjective, but fundamentally cultural, with feedback loops ensuring stability. Super-attractors stand out not only for their capacity to be selected, but also for their capacity to fit in with broader sets of psychological intuitions, generating shared reality and positive expectancies. The advantages of super attractors lie not only in their perceived effectiveness and propensity to be selected in many different contexts, but in their remarkable stability once chosen.