“So he told you to stop swimming?” I interjected.
“Yeah, the breaststroke legs are bad for my hip he said” she replied.
“Was it painful to swim?” ………
“Did it irritate you after?”…….
“No more than usual”……..
“So did you stop?”……..
“Yeah, I haven’t been since”…..
“Have you tried anything else instead?”……..
“No, I thought I’d better check with you first”……..
Spontaneity is an important human trait. Even in the absence of task our brain has spontaneous default neuronal patterns. Constantly probing and engaging our environment. Responding to that around us. When immersed in a task this spontaneous pattern shows some attenuation.
Robots of course are less spontaneous and more about task and compliance. And being honest despite advocating a focus on humanity there are benefits of this. For example it is thought ‘excess’ spontaneous neural patterns lead to more mistakes during task. (Although higher amplitude at rest can predict better task performance). For centuries humans have sought order, documentation and reference, we have encyclopaedias dating back to AD 77. Even the most experienced health professionals will admit the use of Wikipedia or other similar reference points. In this respect we must play second fiddle to robots who can access large swathes of data. So how might spontaneity give us an advantage?
Spontaneity is regarded integral to child’s play and learning. It helps children develop and learn from their environment. The COG project aimed to create a robot who could gain the intelligence of a 2yr old learning only from its environment rather than pre-programmed. This was shelved in 2003. Not so easy it appears.
Is spontaneity rehearsed? For example sporting skills are often honed on the training ground to be used more spontaneously within game. Athletes often describe ‘being in the zone’. The sensation when game comes naturally, easily, spontaneously. Performance subconsciously emerges. You may argue ‘well they plan the move before they execute’. Indeed you must plan (subconsciously) every move before it is executed. Is then spontaneity a charade?
Let us probe deeper then at language and thought. How often do you prepare conversation? Word for word? And your thoughts? When was the last time you planned these? You may think or talk on a theme or topic. But rarely is each detail consciously chosen. It emerges from the subconscious. Spontaneity lies at the heart of who we are as humans. And well it is so given our complex dynamic environments.
Thought, therefore spontaneity, is central to clinical reasoning. Without it we repeat pre-programmed intervention and hope. Algorithm sucks the spontaneity out of interaction. It’s purpose is output, a definitive, an absolute. Not engagement, connection nor plot. This is a particular problem for abductive reasoning processes. Here context is king.
That’s not to say subjective assessment be left to chance. Writers, artists, actors, composers all have subjective method. But this is not algorithmic. Maybe we can learn something. Whether it’s impressionist art, method acting or vernacular novels. They look for ways to engage. To develop meaningful context. Instead of considering the next steps in the algorithm being mindful of what is actually being shared.
I remember vividly someone telling me that I was going to “bollock” them as they’d been on a massive night out for a celebration, plenty of alcohol, dancing on tables, the lot. They described a return of pain the next day as a result. My questions follow:
“Did you have a good night?” An emphatic “Yes” in response.
“How long did it take you to recover?” A sheepish reply “About a day”.
“Overall do you feel any worse now for doing it?” A more confident “No, if anything a bit better!”
“Well that’s good then!” I finished.
I fear early in my career I would have been more “bollocking” in this scenario and laid heavy warnings of fear, caution and sensibility. In fact I doubt I would have made enough connection for anyone to tell me this! I now enjoy these stories alongside people who start self progressing exercise. However if people come looking for permission to restart or need to know exact sets/reps it makes me think deeper. Are they scared? Do they have poor confidence? Do they have time/stress issues and want an easy answer?
To briefly complete the introduction this lady immediately returned to the pool with good effect alongside a specific hip program. Lack of spontaneity often breeds lack of challenge, not wanting to try new things and increased need for planning. This can add extra stress to otherwise routine activities or journeys and may lead to social isolation. Although I recognise for some pacing is required we need to be careful this is not overly stifling. No challenge, no new things, having to pre-plan daily living. Doesn’t sound fun. We have a role in helping people negotiate this, allowing them to be more human (without increasing suffering).
How spontaneous do we allow ourselves to be without compromising task?
How can we promote spontaneity?
Have a method that allows you to know them outside the boxes.
Be more human. Be less robot.
Thanks for getting this far.
An excellent blog by John Doyle demonstrating great outside the box (spontaneous) subjective reasoning http://bit.ly/doyleMS well worth 2mins of you time!
Mennes et al 2011. Linking inter-individual differences in neural activation and behavior to intrinsic brain dynamics. http://bit.ly/mennes1
Eichele 2008. Prediction of human errors by maladaptive changes in event-related brain networks. http://bit.ly/sponterror
The COG project. Wikipaedia. http://bit.ly/cogproject