Uncertainty, vulnerability and control are the three sisters dominating our lives.

There are hundreds of pieces of evidence including serious research that show that human beings ( and animals for that matter) who don’t feel they have some control over their lives suffer all sort of consequences, from anxiety, to depression to physical (‘psychosomatic’) problems. That has always sounded to me as an hypothesis with an easy life. Not that hard to prove. Note I said ‘feel’ which is not the same as actually ‘have or have not’ control. Also, I slotted in another keyword: some.

There is also a lot of data that suggest that our personalities may trick us in that respect. Some people feel that they have a more or less ‘fixed’ programme (whether IQ, circumstances, historical/family baggage) and others feel they can change circumstances, and are not dominated by them. In old Psychology we used to call this internal (it’s in my power) vs. external (it’s not me, it’s my circumstances) ‘locus of control’. More recently, Stanford professor Carol Dweck has seen great popularity with her book ‘Mindset’. A book reportedly read by the Great and the Good, from politics to education. The book says that you either have a Growth Mindset (I can control circumstances, make them malleable) or a Fixed Mindset (I am stuck with what I have, I am, it’s programmed). Mmm, it sounds familiar. Incidentally, I have just given you the shortest free Book Abstract in history.

Some people feel that they have a more or less ‘fixed’ programme and others feel they can change circumstances, and are not dominated by them.

Back to control. One of the situations in which we humans tend to lose or relinquish control is when we are sick and seeing, or waiting to be seen, by a doctor. Our vulnerability increases by the second. Uncertainty goes up, control goes down, anxiety is up, and helplessness is up. Doctors (I was one, if one could ever write this in the past tense) and nurses, tend to play this situation in a very logical and rational manner, which may do nothing for the reduction of vulnerability, for example. Health care professionals?are not always conscious that what for them is a question of fact finding, mental algorithms, protocol and reaching a (diagnosis) conclusion at some point, for the patient is vulnerability, uncertainty, and loss of control.

There would be a way to tackle this, if doctors and nurses would change the way they (often) listen towards providing information and communicating human-to-human. Remember my keywords, ‘some control’. There is an abysmal distance between ‘I don’t know when we will see you’ and ‘I don’t know when we will see you but I will come back in 10 minutes and I will tell you what I know’. Similarly abysmal distance between ‘we will do an X-ray’ and ‘we will do an X-ray in the next 30 minutes, and you will see a doctor within an hour’. Ditto, between ‘You need a blood test’, and ‘I am going to take blood tests now, and the next thing is an X-ray all this morning’.

Giving the patient ‘the now and the next’ is purely behavioural. It’s a choice. It’s an injection of control and reduction of uncertainty. It’s a first step to decrease vulnerability and to remain human, whilst natural anxiety may kick in.

A lot of this is true across contexts; we can make behavioural changes to decrease each others' feelings of uncertainty.

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