Thursday, January 3, 2013

Risks and Fears--Introduction


“Julie, in one of my earlier lives…”

“…You mean, Curmudge, before the turn of the century?”

“…I worked with a group whose task was to allay concerns of the populace about trace organic chemicals in a large river in the West.  As the lab guy, I explained that increasingly sensitive test methods revealed chemicals at parts-per-trillion or (even smaller) quadrillion levels that had been there all along.”

“And did the people buy your explanation?”

“Not entirely.  I believed then that the reason was simply their lack of understanding of the facts.  I was wrong.  The people were fearful, and that’s what we are going to discuss today.”

“I don’t get it, Curmudge.  A fact-based explanation should have done it for the apprehensions of most people.  What went wrong?”

“My employer sent the wrong person.  They sent a chemist, but they should have sent a psychologist.  So now, almost 20 years too late, we’re going to explore the psychology of risk and fear.  Our main resource is a book by David Ropeik (1), and fortunately for us, it’s written in easy-to-handle language.”

“So what, may I ask, does this have to do with leadership and health care?”

“Being a patient in a hospital is a risky experience, Julie, and organizational change evokes a degree of fear in the workplace.  Furthermore, people make unhealthful decisions based on fear and misperceptions.  So don’t leave until the fat lady sings, fictional femme, and we’ll both learn something.”

“Okay, Old Guy.  I’m with you.  Are we going somewhere?”

“We’re going on a hike high in the mountains of Glacier National Park.  You are hiking the trail a few yards ahead of me because I paused to photograph a flower.  As you walk around a bend in the trail, there—a few yards to the right—is a grizzly bear eating berries.  What do you do?”

“I jump, and my heart seemingly ‘leaps into my mouth.’  I hit the ground running back down the trail screaming ‘BEAR’ and looking frantically for a tree to climb.  (There aren’t any; we are above the timberline.)  But what happens to you?”

“You survive because you can run faster than I can.  I survive, too, because the bear is more interested in berries than people.”

“Obviously, our little vignette pertains to fear, and you are going to tell us about it, right?  Hopefully in a semi-nontechnical manner.”

“Right, Julie.  There’s not room to write a book in a blog.  Your first sight of the bear triggered your risk response starting in the brain’s thalamus and—in milliseconds—moving to the part of the brain called the amygdala.  Somehow, the amygdala recognized the signal as indicating danger and told you to jump.  That’s the flight or fight response.  No thinking was involved; you were on autopilot.”

“Hey, Curmudge, I learned that the amygdala was an early arrival in the evolution of the brain.  Our cave man forefathers had an amygdala that told them to be fearful of wild beasts.  If they hadn’t had that, they wouldn’t have been anybody’s forefathers.  Oh, and by the way, the amygdala also stores one’s implicit memory, the memory that we can’t consciously recall.  That’s how I knew that grizzly bears are dangerous without taking time to remember reading about them.”

“Next, the thinking part of your brain, the cerebral cortex, got involved and told you to run back down the trail, shout a warning to me, and look for a tree to climb.  So you see that the bear sighting initiated a lot of activity in your brain in this sequence, fear first and think second.  But sometimes that cognitive activity is a very close second, like your shouting ’bear.’  That was an example of bounded rationality in which you used mental shortcuts (heuristics) as the bases for your almost-instantaneous shout.  Another example of quick mental shortcuts is deciding whether to stop or proceed when a traffic light turns yellow.”

“An influence on your decision is called framing, or how facts are presented.  In the yellow light example, your decision will be influenced by there being a police car next to you or someone tailgating you who might not agree with your decision to stop.  And then there‘s loss aversion.  The cost and inconvenience of being rear-ended may outweigh the cost of paying the fine for running the traffic light.”

“You are really getting into this risk stuff, Julie.  Let’s talk next about why some threats seem scarier than others, which Ropeik calls fear factors or risk perception factors.  They make our fears go up or down and cause us to be more or less afraid.  The difference between the actual risk and the perceived risk is the perception gap.  The author presented a substantial list of risk perception factors, most of which are self-explanatory.  Here are a lot of them: trust, risk vs. benefit, control, choice, natural or man-made, causes pain and suffering, uncertainty, new or familiar, risks to children, and fairness.  And of course, can it happen to me or did it happen to someone I know?”

“Curmudge, I fear that my brain is at risk of exploding if it has to absorb any more information today.  Let’s take a week-long coffee break and return to Risks and Fears later.”

Kaizen Curmudgeon                 

(1) Ropeik, David  How Risky Is It, Really?  (2010, McGraw-Hill) 

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