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Thinking About Thinking
Thinking about my thinking.
Let’s say your sweetie is feeling anxious or stressed or blue or just plain cranky. Would you help her?
Of course, you would. You might start by asking simple, straightforward questions, like: What’s going on? Why are you feeling down? How can I help? Simple, direct questions are effective because they’re thought provoking. They can cover a lot of mental territory. Ambiguous questions help as well. They allow your sweetie to frame her response based on her needs, not yours.
Now, let’s change the frame. If you were feeling anxious or stressed or blue or just plain cranky, would you ask yourself the same questions? I’ve asked this of many people and the most common response seems to be: I don’t think I would think of doing that.
The trick here seems to be the ability to convert a monologue into a dialogue. We all have a little narrator in our heads who comments on what’s going on around us. I call mine the play-by-play announcer because he (she? it?) serves the same function as a sports announcer – narrating the action.
When I watch a sporting event on TV, I just want the narrator to explain what’s going on and why. I want the same of my internal narrator. I don’t normally question the sports narrator; I just go with the flow. I do the same with my internal narrator.
The narrator – whether sports or internal – is in a monologue. It takes an act of imagination to question the narrator. When I’m speaking to my sweetie, it’s natural and obvious to create a dialogue. When I’m speaking to myself, it’s not at all obvious. I don’t naturally think about my thinking.
I’m trying to change that. I’m trying to teach myself a new trick. When I notice certain cues, I ask myself simple, direct questions to better understand the experience. What are the cues? There are at least three clusters:
Cue 1 — when I’m feeling anxious or stressed or blue or just plain cranky. I’ve learned to take note of this condition and use it as a prompt to ask a simple question: Why am I feeling this way? This helps me bring my feelings and desires to a conscious level and sort them out logically. In Daniel Kahneman’s terminology, I’m using my System 2 to check on my System 1.
Cue 2 – when I’m feeling really good, energetic, or enthusiastic. I’d like to feel this way more often. So, when I’m in a great mood, I prompt myself to ask: How did this happen? I’ve discovered some interesting correlations – not all of which I’m going to share. The best correlation may be obvious: Suellen is often around.
Cue 3 – when I have a good idea. I like having good ideas. I feel productive, creative, and smart. So, when I have a good idea, I prompt myself to ask: What was I doing when this idea popped into my head? Again, I’ve discovered some interesting correlations. Most frequently, I’m moving rather than sitting still. I don’t know why that is but I know it works.
I could probably apply the same introspection to other cues as well. At the moment however, I’m just trying to master the trick under these three conditions. What about you? When do you think about your thinking?
The Doctor Won’t See You Now
Shouldn’t you be at a meeting?
If you were to have major heart problem – acute myocardial infarction, heart failure, or cardiac arrest — which of the following conditions would you prefer?
Scenario A — the failure occurs during the heavily attended annual meeting of the American Heart Association when thousands of cardiologists are away from their offices or;
Scenario B — the failure occurs during a time when there are no national cardiology meetings and fewer cardiologists are away from their offices.
If you’re like me, you’ll probably pick Scenario B. If I go into cardiac arrest, I’d like to know that the best cardiologists are available nearby. If they’re off gallivanting at some meeting, they’re useless to me.
But we might be wrong. According to a study published in JAMA Internal Medicine (December 22, 2014), outcomes are generally better under Scenario A.
The study, led by Anupam B. Jena, looked at some 208,000 heart incidents that required hospitalization from 2002 to 2011. Of these, slightly more than 29,000 patients were hospitalized during national meetings. Almost 179,000 patients were hospitalized during times when no national meetings were in session.
And how did they fare? The study asked two key questions: 1) how many of these patients died within 30 days of the incident? and; 2) were there differences between the two groups? Here are the results:
- Heart failure – statistically significant differences – 17.5% of heart failure patients in Scenario A died within 30 days versus 24.8% in Scenario B. The probability of this happening by chance is less than 0.1%.
- Cardiac arrest — statistically significant differences – 59.1% of cardiac arrest patients in Scenario A died within 30 days versus 69.4% in Scenario B. The probability of this happening by chance is less than 1.0%.
- Acute myocardial infarction – no statistically significant differences between the two groups. (There were differences but they may have been caused by chance).
The general conclusion: “High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings.”
It’s an interesting study but how do we interpret it? Here are a few observations:
- It’s not an experiment – we can only demonstrate cause-and-effect using an experimental method with random assignment. But that’s impossible in this case. The study certainly demonstrates a correlation but doesn’t tell us what caused what. We can make educated guesses, of course, but we have to remember that we’re guessing.
- The differences are fairly small – we often misinterpret the meaning of “statistically significant”. It sounds like we found big differences between A and B; the differences, after all, are “significant”. But the term refers to probability not the degree of difference. In this case, we’re 99.9% sure that the differences in the heart failure groups were not caused by chance. Similarly, we’re 99% sure that the differences in the cardiac arrest groups were not caused by chance. But the differences themselves were fairly small.
- The best guess is overtreatment – what causes these differences? The best guess seems to be that cardiologists – when they’re not off at some meeting – are “overly aggressive” in their treatments. The New York Times quotes Anupam Jena: “…we should not assume … that more is better. That may not be the case.” Remember, however, that this is just a guess. We haven’t proven that overtreatment is the culprit.
It’s a good study with interesting findings. But what should we do about them? Should cardiologists change their behavior based on this study? Translating a study’s findings into policies and protocols is a big jump. We’re moving from the scientific to the political. We need a heavy dose of critical thinking. What would you do?
Defining Reality
Is it drunk?
How do you know if someone is dead? Or drunk? Or dead drunk? Or, for that matter, how do you know if the turkey is done?
Suellen loves to cook and often asks me to check up on things. She might ask, “Honey, is the turkey done?” or “Are the madeleines ready to serve?” My standard response is “How would I know?” That’s not as flippant as it might sound. I’m really just asking for the procedure I need to perform to answer the question accurately.
The question revolves around a definition: what does it mean to be “done”? It also involves an operation that I need to perform. To test a turkey, the standard operation (in our house) is to stick a sharp fork in it and, if the juices run clear, it’s ready. It’s an operation that anyone can perform. No matter who performs the operation, the results are the same: if the juices are clear, the turkey is done. If the juices are cloudy, … well, cook it some more. Note that this is not a judgment call. It’s clear to all observers and reliable no matter who does the observing.
The procedure that Suellen prescribes is usually known as an operational definition. You define something by performing a standard, consistent operation. Such definitions form a critical part of critical thinking. Definitions are fundamental. If they’re solid, you can build a logical argument on top of them. If they’re wobbly, it doesn’t matter how good the rest of your logic is – the foundation won’t support it.
How would you define drunkenness? You may know what it feels like to be drunk. You may also know what person looks like (or smells like) when he’s drunk. But your view and mine may be different. You may think he’s drunk; I may think he’s a dork. Though we make the same observation, our conclusions are different. We don’t have a reliable, observable, objective test of drunkenness.
So, let’s operationalize drunkenness. We’ll ask the person to breathe into a breathalyzer. We’ll also agree on a number that defines drunkenness. In Colorado, that number is 0.08 grams of alcohol per deciliter of blood. The person breathes into the device and the reading comes out 0.09. The reading is observable, objective, and reliable. In Colorado, the person is legally drunk and should not drive a car.
Notice also that we choose the number by agreement. There’s nothing magical about 0.08 – we’ve simply agreed on it. (The risks of an accident do increase as compared to, say, 0.04). In Sweden, which aims to eliminate all traffic fatalities, the cutoff is much lower: 0.02. So, it’s possible to be drunk in Sweden while being perfectly sober in Colorado.
What about the definition of death? You wouldn’t want to get that wrong. It used to be simple: just take the person’s pulse. If there is no pulse, the person is dead. It’s an operation that’s observable, objective, and reliable. However, the definition has changed in the recent past. We now focus more on brain activity than on pulse. We have new operations to perform.
When building a logical argument, it’s always good to probe the definitions. They dictate how we perceive phenomena and gather data. Having good definitions doesn’t necessarily mean that you’ll have a good argument. On the other hand, bad definitions necessarily lead to failed arguments.
And, how about those madeleines? I just can’t remember. I’ll ask my friend, Marcel.
Mind and Body
Happy Girl
How much does your body affect your brain? A lot more than we might have guessed even just a few years ago. The general concept — known as embodied cognition – holds that the body and the brain are one system, not two. (Sorry, Descartes). What the body is doing affects what the brain is thinking.
I’ve written about embodied cognition before (here and here). Recently, I’ve seen a spate of new stories that extend our understanding. Here’s a summary:
The power pose – want to perform better in an upcoming job interview? Just before the interview, strike a power pose for two minutes. Your testosterone will go up and your cortisol will go down. You’ll be more confident and assertive and knock ’em dead in the interview. Amy Cuddy explains it all in the second most-watched TED video ever.
Willpower, dissension, and glucose – If you run ten miles, you’ll deplete your energy reserves. You may need to relax and refuel before taking up a new physical challenge. Does the same thing happen with willpower? Apparently so. If you resist the temptation to smoke a cigarette, you’ll have less willpower left to resist eating a donut. You can use up willpower just like you use up physical power. Perhaps that’s why you’re more likely to argue with your spouse when your glucose levels are low. If you sip a glass of lemonade, you might just avoid the argument altogether.
Musicians have better memories – experiments at the University of Texas suggest that professional musicians have better short- and long-term memories than the rest of us. For short-term memory (working memory), the musicians are better at both verbal and pictorial recall. For long-term memory, they’re better at pictorial recall. Maybe we should invest more in musical education.
How you walk affects your mood – as the Scientific American points out, “A good mood may put a spring in your step. But the opposite can work too: purposefully putting a spring in your step can improve your mood.” As Science Daily points out, the opposite is also true. If you walk with slumped shoulders and head down, you’ll eventually get grumpy. Your Mom was right: standing up straight actually does affect your mood and performance.
Intuition may just be your body talking to you – when you get nervous, your palms may start to sweat. Your mood is affecting your body, right? Well, maybe it’s the other way round. Your intuition (also known as System 1) senses that something is amiss. It needs to get your (System 2) attention somehow. What’s the best way? How about sweaty palms and a racing heartbeat? They’re simple, effective signaling techniques that are hard to ignore.
The power of a pencil – want to get happy? Hold a pencil in your mouth like the woman in the picture. Your facial muscles act as if they’re smiling. You may consciously realize that you’re not smiling but it doesn’t really matter – your body is doing the thinking for you.
Ebola and Availability Cascades
We can’t see it so it must be everywhere!
Which causes more deaths: strokes or accidents?
The way you consider this question speaks volumes about how humans think. When we don’t have data at our fingertips (i.e., most of the time), we make estimates. We do so by answering a question – but not the question we’re asked. Instead, we answer an easier question.
In fact, we make it personal and ask a question like this:
How easy is it for me to retrieve memories of people who died of strokes compared to memories of people who died by accidents?
Our logic is simple: if it’s easy to remember, there must be a lot of it. If it’s hard to remember, there must be less of it.
So, most people say that accidents cause more deaths than strokes. Actually, that’s dead wrong. As Daniel Kahneman points out, strokes cause twice as many deaths as all accidents combined.
Why would we guess wrong? Because accidents are more memorable than strokes. If you read this morning’s paper, you probably read about several accidental deaths. Can you recall reading about any deaths by stroke? Even if you read all the obituaries, it’s unlikely.
This is typically known as the availability bias – the memories are easily available to you. You can retrieve them easily and, therefore, you overestimate their frequency. Thus, we overestimate the frequency of violent crime, terrorist attacks, and government stupidity. We read about these things regularly so we assume that they’re common, everyday occurrences.
We all suffer from the availability bias. But when we suffer from it simultaneously and together, it can become an availability cascade – a form of mass hysteria. Here’s how it works. (Timur Kuran and Cass Sunstein coined the term availability cascade. I’m using Daniel Kahneman’s summary).
As Kahneman writes, an “… availability cascade is a self-sustaining chain of events, which may start from media reports of a relatively minor incident and lead up to public panic and large-scale government action.” Something goes wrong and the media reports it. It’s not an isolated incident; it could happen again. Perhaps it could affect a lot of people. Perhaps it’s an invisible killer whose effects are not evident for years. Perhaps you already have it. How would one know? Or perhaps it’s a gruesome killer that causes great suffering. Perhaps it’s not clear how one gets it. How can we protect ourselves?
Initially, the story is about the incident. But then it morphs into a meta-story. It’s about angry people who are demanding action; they’re marching in the streets and protesting in front of the White House. It’s about fear and loathing. Then experts get involved. But, of course, multiple experts never agree on anything. There are discrepancies in the stories they tell. Perhaps they don’t know what’s really going on. Perhaps they’re hiding something. Perhaps it’s a conspiracy. Perhaps we’re all going to die.
A story like this can spin out of control in a hurry. It goes viral. Since we hear about it every day, it’s easily available to our memories. Since it’s available, we assume that it’s very probable. As Kahneman points out, “…the response of the political system is guided by the intensity of public sentiment.”
Think it can’t happen in our age of instant communications? Go back and read the stories about ebola in America. It’s a classic availability cascade. Chris Christie, the governor of New Jersey, reacted quickly — not because he needed to but because of the intensity of public sentiment. Our 24-hour news cycle needs something awful to happen at least once a day. So availability cascades aren’t going to go away. They’ll just happen faster.
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