Paradoxical instructions?
In an ultrasound exam, when I prompt patients in their bed to lie on their back - this usually happens in a moment where they lie on their right or left side or when they sit - more than half of them turn around on their belly. This is a funny paradox. It happens to my colleagues as well. I don't know why, maybe patients think: well, I am already on my back but the doc wants me to change my position, so it must be the other side he's talking about. I suppose they try to cooperate, so when they don't know what to do, they do the thing that seems to fit best. "Lie down!" works better. But say "Lie down on your back!" - and they will be on their belly.
posted by Pat se Doc at 7:23 PM
1 Comments:
This is not so surprising, I should think. The content of your message is not so important to the language processing of your patients at that moment. It's just the fact that you add extra information to the prototypical instruction of "lie down" - I would suspect that the ordinary way for most people to think of lying down would imply lying on their back. Hence, a request that elaborates further on the exact nature of lying down requires more processing and regardless of the contents, especially in a concentrated setting like a clinic, it might be the excess info that is causing patients to modify their behaviour. The fact that you basically instruct them twice to do the same thing, i.e. "lie down" and "on your back" is perceived as a paradoxical instruction - not on a lexical level but on a pragmatic level of language processing.
But why? The extra amount of language processing that would be required to notice the "double-post" counters your patients expectations of a physician who is prototypically represented in our culture as a smart guy - why would he ask you twice to do the same thing? "There MUST be an extra meaning to what he says" - or would you ask someone: excuse me, could you please pass me the salt in the salt container? now add an asymmetrical relationship to this process where it is your right to request any information you please: passing the salt or lying down on the back may become a task that is simply too difficult both to processes linguistically as well as physically....
you could also argue that by being asked to process too much contradictory info, your patients simply show you their...
7:36 AM
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