• Keaton Worland

A Brief Lesson From A Mule

Decision making can be difficult and even paralyzing at times, especially with the amount of information now readily accessible at our fingertips. As I consider the effects this is having on our industry, I am more pulled to how this may be affecting client/patient decisions.

Buridan’s Mule has helped me better appreciate this perspective. The Tale Goes:

There was a wandering Mule that was hungry. The Mule searched the land for food until he found a source. However, when the Mule found his food he found himself between two bales of hay, one to the left and one to right. They were identical in size. They were an equidistant away. The Mule had a decision to make, which bale to eat from, but because the bales were the same size and distance away, the Mule could not make a decision. The Mule stood contemplating the best option, but to no avail. The Mule continued to be stymied until it starved to death.

Now I can't help but imagine this must resemble how a client/patient feels as they try and decipher the information provided to them by the healthcare system as well as the internet. The Mule in this tale does not die of hunger but from the effects of indecision and a lack of action. The indecision in this scenario as with many client/patients magnifies a feeling of uncertainty. And standing with uncertainty and indecisiveness will stagnant/alter behavior due to a loss of situational awareness.

Now it is assumed uncertainty in action is associated with some level of risk. This can't be assumed though. Decision making under conditions of uncertainty are different than those conditioned by risk. This can be understood better through the study of probability. When we decide to engage in a "risky" behavior although the outcome is unknown, the probability distribution governing the outcome is known, meaning we are aware of what could happen. However in contrast to risk, conditions of uncertainty neither the outcome or the probability distribution is known. Anything could happen.

An unknown outcome yields countless mind games and "what if" scenarios. By not knowing the risk of a situation the brain defaults towards maximum protection, often leading to increased tension (physical and cognitive) to ensure organism safety. This often results in an increase in averse behaviors.

It is these averse behaviors that so often prevent a client/patient from making any true progress. They are still too uncertain of their actions. They still don’t know why they should believe your instruction over the internet or their last coach/therapist. So rather than continuing to simply prescribe exercises for home, try filling in their knowledge gaps so that they better understand the why behind their actions. If you meet the client/patient where they are and have a discussion they will be much more willing to move in the direction you are pointing them.

Knowledge as a liberator.

Stay Well.

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