How Mental Shortcuts Impact Recovery
Posted on January 17 2018
“So am I better now?” This common question is often asked by patients during recovery. My response varies, but most of the time I explain that “better” is not all-or-none. “Better” happens gradually over time as our bodies heal. Most people would agree with that simple principle. However, during recovery, folks want to know how they are progressing on their scale of healing.
Mental Decision-Making: Heuristics
Pondering the patient question of “am I better” led me to reflect back on my days as an undergraduate psychology student at The University of Iowa. We learned about a principle known as heuristics. In short, heuristics are mental shortcuts that humans use to judge situations without having to think about the complexity of the situation. Most of the time, these mental shortcuts are rational to use; they lead to quick, efficient decision-making without expending too much time and energy.
Here’s a real-life example of how we use heuristics in our daily lives… Let’s say you pull up to a four-way intersection with signs that look like red octagons, but they do not say “STOP.” For most of us, a visual queue involving a red octagon in a driving situation means “STOP!” As you approach, you’d likely make the decision to stop, especially if you noticed other drivers stopping in front of the red octagons. Most people would not do a Google search or ask for clarification because these mental shortcuts have allowed us to make a reasonable decision (ie. red octagon = stop).
However, once in a while using heuristics leads to errors. We see this in our daily lives when we make snap judgments about a person, only to learn later that we were completely wrong. The information that was gathered about this particular person was not enough to make a correct judgment.
Heuristics and Physical Therapy
You may be asking how heuristics relates to physical therapy, and I’ll now explain my thinking… When patients ask me if they are better yet, I have learned that sometimes they are actually asking, “Am I completely healed yet?” Many times during rehab the answer to this question is, “No.” But it would not be wise to stop there; the process of healing is much more complex than the simple heuristic of “All the way better” or “Not better at all”. Reflecting on all the changes that have occurred since beginning physical therapy takes time and energy, but this is essential when trying to assess where you are in the gradual healing process.
Here is the take-home point: “Better” lies on a spectrum. It is very unusual for a patient to receive one treatment and be completely cured of pain or dysfunction, but usually there is some type of improvement. Gradually there are more improvements, and over time the body completely heals and is restored to full function. The following is a graphic representation of what I’m talking about.
Physical Therapy Advice
To avoid some common frustrations that may surface during your journey to recovery, please keep the following in mind:
Realize that you may be prone to using heuristics, such as, “I feel better, therefore I must be cured!” or “I still hurt sometimes, therefore I must not be getting any better.” In other words, avoid “I am either cured, or not getting any better at all.” Remember, even if you feel good one day does not necessarily mean that your body is completely healed. Likewise, if you feel worse one day, it does not mean that you haven’t healed at all. There are always ups and downs in the healing process. Realize that “better” lies on a spectrum, and it takes thoughtful reflection to realize where you are on this spectrum.
Clearly communicate with your physical therapist. Ask your therapist if what you are experiencing is normal. Let your therapist know about changes that occur—either for the good or the bad. Be specific when you say that something feels better, worse, or the same. What activities specifically feel better or worse? Sometimes simply having a dialogue regarding your recovery will help put everything in perspective.
As humans, we are creatures of habit. In spite of our best efforts to override our knee-jerk reaction to life’s situations, we’ll likely never stop using heuristics (nor should we). They have helped us make sense of and survive a very complex and sometimes dangerous world. There is benefit, though, in recognizing when we are using them, because some situations do require complex thought and reflection, such as assessing our improvements after an injury.
If you are experiencing pain or dysfunction and would like to meet with a physical therapist who can help with your recovery efforts, please contact Fit Physical Therapy today. With 7 locations in the Denver area, there is sure to be a clinic near you. Call 303-409-2133 today to schedule an appointment.
Yours for incremental healing,
Dr. Emily Kelly, DPT, Centennial Clinic
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