Tuesday, March 29, 2016


                 A few years back I fortunate to converse (on line) with Daniel Kahneman (author of Thinking Fast and Slow) regarding the association between our being in a vacation- relaxed mode and our increased susceptibility for mistakes. He explained to me the when we are in a happy and loose mood, our guard is down. Yes, we are more creative and intuitive, but much less vigilant and prone to error (lazy). It is during this low-threat state that we are less likely to double check challenges and solutions (the ‘how many animals did Moses take on the ark' experiment).
       I happened to have the opportunity to talk on the phone with Psychologist Mihaly Csikszentmihalyi (founder and co-director of the Quality of Life Research Center) who has spent his life investigating flow or the "optimal experience" (what makes an experience genuinely satisfying; the state of consciousness called flow). It occurred to me that this is the perfect setup to being prone to error and I wanted his take on this. He did not balk. Apparently he has interviewed many in high risk environments about this particular concern: ie how can you simultaneously enjoy an experience and not die rock-climbing, jumping, skiing etc. He said it is simply like skiing; you enjoy the scenery, the terrain, your companionship, but an experienced skier, knows to be wary of the weather and the trees. “If all you think about is the scenery, you will end up in the trees.” He said that during the writing of his book Beyond Boredom and Anxiety, he interviewed surgeons to see how they continued functioning in a stressful environment but enjoyed their work. Seems that the surgeons he spoke with had a knack for being able to simultaneously think of their work as a craft but at the same time be on guard for potential mistakes. The ones capable of focusing positive energy on their success and the enjoyment they had, did well. He likened this to jumpers; as a jumper (he says) you must pay close attention to your mark, elevation etc. You become distracted for a second and it could mean death. The ones who suddenly focus on the potential fall and mistakes that could occur as they are about to perform their feat tend to have near misses, so they focus on the act of flying through the air and perfecting the landing (not the fall or hard ground). So somewhere in the midst of those successful in high risk sports or career is the inherent ability to enjoy their work and “be in the zone” but simultaneously know when potential mistakes could occur and keep an eye out for those situations.

Kenneth A. Lipshy, MD, FACS

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