Mental models, medical misunderstandings, and expressive and instrumental behaviour

By Gordon Rugg

A frequent and enduring topic of complaints about medical professionals is their bedside manner.

Three common complaints are:

  • My doctor won’t listen to me
  • My doctor is cold and impersonal
  • My doctor doesn’t give me the facts

These can be explained and handled via the concepts of instrumental and expressive behaviour. Instrumental behaviour is about getting the job done; expressive behaviour is about showing how you feel about something. I’ve blogged about these concepts and their implications here and here and here.

These categories are not mutually exclusive; some people are very strong both on instrumental and on expressive behaviour, for instance. However, people tend to incline more to one than the other. The “people person” with good social skills is typically good on expressive behaviour, while the archetypal “techie” is strong on instrumental behaviour.

The issue of expressive versus instrumental behaviour is a common cause of serious misunderstandings across many domains; medicine is a classic case. Fortunately, many of these misunderstandings can be fairly easily prevented. In this article, I’ll describe the underlying concepts, and how to use them to reduce the number and severity of complaints.

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Mental models, and games people play

By Gordon Rugg

There are patterns in the ways that people interact. This article is about those patterns, and their implications.

I’ll start with a pattern known as “Ain’t it awful”. In this pattern, the other person wants you to agree with them that things are awful. I’ve shown this diagrammatically below. The interaction starts with you saying something; I’ve shown this with a white circle. They then respond with something negative, represented by a grey circle. For instance, you might tell them that you’re thinking of buying an electric car. They react by saying something about problems with electric cars.

They now want you to respond with something negative; for instance, “That’s the trouble with new technology, you can’t depend on it”. The interaction is then supposed to follow the same pattern of “Ain’t it awful” in a nice, predictable way, as shown below.

This may be nice and safely predictable for them, but it’s not so nice for you if you don’t want to be told about things being awful, and it’s not so predictable for you if you’re expecting a different type of interaction.

In the rest of this article, I’ll look at ways in which interactional patterns can play out.

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Mental models, and making sense of crazy uncles

By Gordon Rugg

The crazy uncle is a well-established and much-dreaded part of Western culture. There’s probably a very similar figure in other cultures too, but in this article, I’ll focus on the Western one, and on what is going on in his head.

Why are crazy uncles permanently angry, and keen to inflict their opinions, prejudices and conspiracy theories on other people? Some parts of the answer are already well covered in popular media and in specialist research, but other parts are less well known.

In this article, I’ll give a brief overview of the better known elements, and then combine them with insights from knowledge modeling, and see what sort of answer emerges.

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Mental models and metalanguage: Putting it all together

By Gordon Rugg

The previous articles in this series looked at mental models and ways of making sense of problems. A recurrent theme in those articles was that using the wrong model can lead to disastrous outcomes.

This raises the question of how to choose the right model to make sense of a problem. In this article, I’ll look at the issues involved in answering this question, and then look at some practical solutions.

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Mental models, worldviews, Meccano, and systems theory

By Gordon Rugg

The previous articles in this series looked at how everyday entities such as a cup of coffee or a Lego pack can provide templates for thinking about other subjects, particularly abstract concepts such as justice, and entities that we can’t directly observe with human senses, such as electricity.

The previous articles examined templates for handling entities that stay where they’re put. With Lego blocks or a cup of coffee, once you’ve put them into a configuration, they stay in that configuration unless something else disturbs them. The Lego blocks stay in the shape you assembled them in; the cup of coffee remains a cup of coffee.

However, not all entities behave that way. In this article, I’ll examine systems theory, and its implications for entities that don’t stay where they’re put, but instead behave in ways that are often unexpected and counter-intuitive. I’ll use Meccano as a worked example.

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Mental models, worldviews, and mocha

By Gordon Rugg

Mental models provide a template for handling things that happen in the world.

At their best, they provide invaluable counter-intuitive insights that let us solve problems which would otherwise be intractable. At their worst, they provide the appearance of solutions, while actually digging us deeper into the real underlying problem.

In this article, I’ll use a cup of mocha as an example of how these two outcomes can happen. I’ll also look at how this relates to the long-running debate about whether there is a real divide between the arts and the sciences as two different cultures.

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Mental models, worldviews, and the span of consistency

By Gordon Rugg

In politics and religion, a common accusation is that someone is being hypocritical or inconsistent. The previous article in this series looked at how this can arise from the irregular adjective approach to other groups; for example, “Our soldiers are brave” versus “Their soldiers are fanatical” when describing otherwise identical actions.

Often, though, inconsistency is an almost inevitable consequence of dealing with complexity. Mainstream political movements, like organised religions, spend a lot of time and effort in identifying and resolving inherent contradictions within their worldview. This process takes a lot of time and effort because of the sheer number of possible combinations of beliefs within any mature worldview.

In this article, I’ll work through the implications of this simple but extremely significant issue.

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