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 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, and the Other as dark reflection.

By Gordon Rugg

This article is the first in a series about mental models and their implications both for worldviews and for everyday behaviour. Mental models are at the core of how we think and act. They’ve received a lot of attention from various disciplines, which is good in terms of there being plenty of material to draw on, and less good in terms of clear, unified frameworks.

In these articles, I’ll look at how we can use some clean, elegant formalisms to make more sense of what mental models are, and how they can go wrong. Much of the classic work on mental models has focused on mental models of specific small scale problems. I’ll focus mainly on the other end of the scale, where mental models have implications so far-reaching that they’re major components of worldviews.

Mental models are a classic case of the simplicity beyond complexity. Often, something in a mental model that initially looks trivial turns out to be massively important and complex; there’s a new simplicity at the other side, but only after you’ve waded through that intervening complexity. For this reason, I’ll keep the individual articles short, and then look in more detail at the implications in separate articles, rather than trying to do too much in one article.

I’ll start with the Other, to show how mental models can have implications at the level of war versus peace, as well as at the level of interpersonal bigotry and harrassment.

The Other is a core concept in sociology and related fields. It’s pretty much what it sounds like. People tend to divide the world in to Us and Them. The Other is Them. The implications are far reaching.

The full story is, as you might expect, more complex, but the core concept is that simple. In this article, I’ll look at the surface simplicity, and look at the different implications of two different forms of surface simplicity.

It’s a topic that takes us into questions about status, morality, and what happens when beliefs collide with reality.

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Surface structure and deep structure

By Gordon Rugg

The concepts of surface structure and deep structure are taken for granted in some disciplines, such as linguistics and media studies, but little known in others. This article is a brief overview of these concepts, with examples from literature, film, physics and human error.

The core concept

A simple initial example is that the surface structure of Fred kisses Ginger is an instantiation of the deep structure the hero kisses the heroine. That same deep structure can appear as many surface structures, such as Rhett kisses Scarlett or Mr Darcy kisses Elizabeth Bennet.

There are various ways of representing surface and deep structure. One useful representation is putting brackets around each chunk of surface structure, to clarify which bits of surface structure map onto which bits of deep structure; for example, [Mr Darcy] [kisses] [Elizabeth Bennet].

Another useful representation shows the surface structure mapped onto the deep structure visually. One way of doing this is as a table, like the one below.

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The simplicity beyond complexity

By Gordon Rugg

The simplicity beyond complexity is a concept attributed to Oliver Wendell Holmes Jr. It appears in at least a couple of forms, as described below.

“I would not give a fig for the simplicity this side of complexity, but I would give my life for the simplicity on the other side of complexity.” This quote, which on the Holmes Sr page has “my right arm” instead of “my life,” is one for which I haven’t found the source so far, and so I will leave this quote as it is on both pages. – InvisibleSun 18:05, 10 October 2006 (UTC)

It’s interpreted in at least a couple of ways.

One way, which I won’t go into here, is about working out how to solve a problem, and then hiding the complexity of the solution from the user, so that the product is simple to use.

The other way, which I will go into below, is about why apparently sensible simple explanations often don’t work, and about why there’s often a different but better simple explanation that only emerges after a lot of complexity, confusion and investigation.

Adapted from:

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