Those of you who have been through the ACN seminars might remember:
It was always partly tongue in cheek.
But it turns out there may be some rather interesting psychology behind it.
I recently bumped into an old friend I hadn’t seen for many years.
The friendship hadn’t ended impulsively, it was a slow decline. I realised he just consistently made me feel bad.
I just slowly stopped seeing him.
Then I randomly saw him walking on the beach and we talked.
And suddenly…..
“Was it really that bad?”
“Did I make a mistake?”
“Perhaps we should be friends again?”
The interesting bit is that nothing about the original friendship had changed.
What had changed was my memory of how it felt.
Meet the Fading Affect Bias
When we remember emotional events, their emotional intensity generally diminishes with time.
But crucially, research suggests that the negative emotion associated with unpleasant autobiographical memories tends to fade faster than the positive emotion associated with pleasant ones.
Which is probably a very good thing.
Imagine experiencing the full emotional intensity of every painful event in your life whenever you remembered it.
Instead, our psychological volume control gets quietly turned down.
The problem?
Sometimes it turns down the warning signal as well.
And this brings us straight back into clinic.
Think about the patient who originally couldn’t sleep because of their back pain.
They couldn’t exercise.
Couldn’t sit comfortably at work.
Couldn’t pick up their child without worrying.
So together you changed things.
- Adjusting.
- Rehabilitation.
- Exercise.
- Sleep.
- Diet.
Perhaps correcting nutritional deficiencies and introducing appropriate supplements:
B12
Vitamin D
Magnesium
Six months later they’re back in the gym, sleeping normally and barely thinking about their back.
Fantastic.
Until…
“Do I really need to keep doing the exercises?”
“Do I need to keep taking this?”
“I’m feeling fine now, do I really need another appointment?”
They miss one and do not have another prebooked and never get back to you…..
And here we encounter a wonderful paradox:
The success of the intervention becomes the argument for abandoning the intervention.
Progress gradually destroys the patient’s emotional memory of why they started doing these things in the first place.
They remember that their back hurt.
They don’t necessarily remember what having that back pain cost them. They do not remember the emotional distress it caused.
That’s the distinction.
And it’s why Commandment 12 matters.
This doesn’t mean keeping patients on unnecessary treatment or supplements forever.
Quite the opposite.
We should regularly reassess what’s necessary.
But perhaps part of good clinical management is helping patients maintain some borrowed authority from their former selves.
“Remember when you couldn’t drive for 20 minutes?”
“Remember when you were waking three times every night?”
“Remember why we introduced this in the first place?”
Not to scare them into compliance, but to help them make better decisions.
Can they remember how the pain and subsequent loss of function made them feel?
Because present patient has one enormous advantage over past patient:
They feel better.
But the past patient possessed something the present patient no longer has.
A vivid memory of what being ill actually felt like.
Sometimes our job isn’t just helping patients get better.
It’s making sure that feeling better doesn’t make them forget how they got there.