Your first instinct is that this article is wrong.

 

Now reflect for a moment. Where did that feeling come from? What evidence do you have for that feeling? You’re only five sentences in, and you have made a decision about this article’s validity…and we haven’t even gotten to the point!

 

Oftentimes, in clinical discussions, we hear therapists advise other therapists that they should just “trust your gut”. But what if the legal and ethical ramifications fell to you as the advice giver in these situations? If the person receiving your advice is then subsequently sued or brought in front of an ethics board because of the advice, would you be willing to give the same advice again? Especially when the context of the situation is boiled down to a few short sentences in a message board, Facebook group, or some other remote forum. This might be practical advice for a close colleague, supervisee or consultee for some extended period of time, or perhaps a loved one or immediate family member. But a stranger or person on the internet whom you have only had a few interactions with in a semi-occasional basis. Or worse, what if the person receiving your advice is a bad actor—a therapist that is looking to justify actions against a protected class of clients? Are you still quick to say “trust your gut” to someone that is using that reasoning to justify their own feelings against minorities, LGBTQ+ clients, or people with disabilities? Are you comfortable with your role in perpetuating these stigmas?

 

If your advice is not consistent between what you give a close friend and an internet stranger, why not? Obviously the ethics police are not going to come chasing after you for giving (potentially) bad advice on the internet, instead they will blame the receiver of the advice for not taking due diligence in their decision-making process. So other than the consequence free environment of giving the advice, you are still potentially not giving good advice.

 

Decades of research into clinical intuition says that it can be developed, but the advice that we give in these situations usually does not follow the conditions to actually come from intuition. Psychologist Daniel Kahneman (fun fact: the only psychologist to ever win a Nobel Prize) laid out that these conditions are: A) regularity where learning can occur, B) a lot of practice, and C) immediate feedback.

 

Kahneman also conceptualized that we tend to process information in two ways; with System 1 being an automatic system that is based on impressions, intentions, and feelings while System 2 is an effortful, rational, sequential and slow process. If System 1 is constantly giving information to System 2, then when System 2 confirms it, it turns into a belief system that strengthens and reinforces System 1. Want proof? Look at the following words:

 

TEQUILA                                          VOMIT

 

Your brain used System 1 information to create a powerful intuitive response. In the middle of an article about something completely else, you may have experienced a physical reaction, memories of bad choices at parties in college, and much more. These System 1 thoughts are strongly ingrained, so much so that our System 1 brains create a cause and effect connection before our System 2 thoughts to break down that there is no tequila in the moment, nor is there any vomit.  But why are we talking about this here?

 

In the absence of tequila, these System 1 thoughts are affecting you, possibly to the point of making decisions and recommendations for others. But when you slow down to engage in System 2 thoughts, a deliberate practice that many of us do not engage in fully enough before making recommendations. When we engage in good System 2 thoughts, we aren’t so quick to make recommendations. When making recommendations to others, we have to decide if we are making System 1 thoughts without engaging in the systematic work that comes along with System 2 thoughts. Another example when it comes to a client presenting for intake:

 

CLIENT WITH HISTORY OF VIOLENCE                        EMPTY OFFICE SUITE

 

The System 1 thoughts are strong (clinician fear of being alone with a client with a history of violence), but do System 2 thoughts get worked in? At best, possibly. Do we have enough experience in conditions A, B, & C to warrant this decision? Checking in:

 

Condition A)

The number of times that we have clients with a history of violence coming in to our offices varies wildly from one clinician to the next, especially in conditions of an empty office suite. You and your experience of being with a client with a history of violence may be relatively small, which violates this condition. The same may hold for the advice receiver. Without regularity of practicing in this condition, an intuition experience is not present.

 

Condition B)

Regular practice. If regularity does not occur, then there is not a regularity to practice it. This condition is also violated.

 

Condition C)

While the immediate feedback of a therapist “not being attacked” satisfies condition C, it is irrelevant because both conditions A & B have not been tested.

 

Giving this advice must come with practice, it must come with regularity, and it must come with testable conditions and openness to engage in all sides of System 2 thinking that seeks out both confirming and disconfirming evidence. If the person asking for advice and validation does not meet these conditions, it gives an opportunity to ask conditions that engage System 2 thinking. But consider that you, too, might not meet the three conditions laid out by Kahneman and are also only engaging in System 1 thinking. It is with these careful considerations that we seek to both confirm and disconfirm the evidence before arriving to a conclusion and making a recommendation. Instead, the questions need to follow structured System 2 thinking, such as “What evidence supports and negates the System 1 thinking?” “What does ethical decision making in this process look like?” and “Are we just utilizing other people’s System 1 thinking to validate the advice seekers System 1 thinking?” Until then, it’s just bad advice.

 

Kahneman, D. (2011). Thinking fast and slow. New York: Penguin Books Ltd.

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