Algorithm is going to get you (Kappitel 2: Spontaneity)

“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?” ………

“A bit”……..

“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.

Spontaneous

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.

AbdReason

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.

Neil

Further Reading

An excellent blog by John Doyle demonstrating great outside the box (spontaneous) subjective reasoning http://bit.ly/doyleMS well worth 2mins of you time!

Content

Brembs. http://bit.ly/spontbrain

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

6 thoughts on “Algorithm is going to get you (Kappitel 2: Spontaneity)”

  1. Hello Neil,

    Follows on well from where you left off. I think spontaneity may come with knowledge and good experience. However, I do not think knowledge should stop someone being spontaneous.
    For example, I had a gentleman a while ago who developed foot drop whilst on treatment. I couldn’t find a pattern to it that I recognised and so, as you say, went over everything spontaneously. I came to a stop so when a medication he had recently started to take was discussed. To be honest I went and looked it up, saw reports of side effects and wrote a letter to his GP. His GP took him off the drug and his full muscle power returned. So perhaps sometimes being spontaneous helps, even if you need to take a time out to analyse your findings.
    I wouldn’t like to be responsible for designing an algorithm. To cover every variable it would be vast and then miss the point. Also, any faults in it would render it useless and lead to perseveration i.e. people continuously using it and believing it to be the truth, despite continually getting the same wrong outcome.
    What are your thoughts on the integration of reflection before action, in action and on action with spontaneity. I would be interested to know.

    Thank you for this.

    Kind regards,

    Adrian

    Liked by 2 people

    1. great example! yes spontaneity should take you beyond obvious or simple thought. Not a direct replacement.

      Thoughts on reflection are a bit sparse. I think you can cultivate spontaneity but difficult to force it. You are almost working off your sub-conscious (in a way). I think there may be a link with spontaneity and mindfulness (in action). But not thought too much on pre-reflection!

      What are your thoughts??

      Like

  2. Hello again Neil,

    Just thinking for example you get a referral with a bit of info on like LBP had previous physiotherapy. Having recurrent episodes.
    You may think why recurrent episodes, what happened in the previous physiotherapy. Will you have to dispel some myths about treatment for LBP and if so how might you do it without making them feel let down or a bit stupid etc.
    Will this reflection affect or inform your spontaneity when the event happens. Or will the event be totally different from what you prepare for but because of this it still affects your spontaneity.
    Or is what I am writing drivel.
    I find this type of blog very thought provoking. It is not just a narrative of what someone did.I suppose there are no answers just more questions and varied conclusions.

    Regards

    Liked by 1 person

    1. Excellent points. I am interested in exploring how spontaneity and consciousness combine.

      Essentially we have lots of stored data, movement patterns etc but we cannot be conscious of them all at once as it would be overload.

      I guess my theory would be is spontaneity when your sub-conscious and conscious meet?

      For example with LBP we may have a thought or assessment trajectory. But we are limited to how much our conscious can ‘hold’. If they were to mention something that ‘touches’ our sub-conscious understanding/knowledge/world I would consider this a spontaneous moment that halts or jolts your trajectory and allows to gather different maybe better info. Eg they mention abdo pain, pataesthesia, unusual symptoms.

      Or from a skills point of view. Say as you dribble a football a situation or context develops which touches your sub-conscious that a certain skill, pass etc may be appropriate then again I would call this spontaneity as you become aware of it in the moment.

      Great to hear your thoughts! Certainly helping me to process my thoughts!

      Like

  3. Morning,

    Everything is linked to everything else it seems. What can happen will happen in a way.
    It is difficult to look at anything in isolation I think.

    Regards

    Liked by 1 person

    1. Complexity makes more sense meta-physically (to me at least). And works against determinism where a leads to b leads to c etc.

      The difficulty can be finding things that make more difference. Reasoning, data, spontaneity may all help this process.

      Like

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