Influence Patient Decisions by Talking to the Elephant

 ([Excerpt from upcoming book, Prescribing Change: How to Make Connections, Influence Decisions and Get Patients to Buy Into Change] 

In the bestselling book Switch: How to Change Things When Change Is Hard, Chip and Dan Heath describe the emotional versus logical sides of our brain and the effect of each on our decisions and actions.

• The logical, rational side analyzes our options and thinks long-term. This part of the brain is very good at self-control. The authors call it the “the rider,” referring to a rider on the elephant described below.
• The emotional side of the brain feels pleasure, pain, love, empathy, and so on. It’s more short-term oriented and seeks instant gratification. The authors call this “the elephant.”

To summarize the analogy, most of us envision ourselves as the rider, in complete control of our actions and decisions and directing the path forward. What we fail to realize is that we’re all riding around on a 12,000-pound elephant that’s dragging us through life doing what it “feels” like doing.

While most of us like to think we are very much in constant control of our lives, in reality we go through much of our existence on autopilot. Depending on what time of the day you’re reading this, you’ve probably already made hundreds if not thousands of small decisions today. If that seems like a lot, it’s probably because you didn’t have to exert much mental energy into those decisions. As discussed above, most of these decisions were made at a subconscious level. According to Harvard marketing professor and author Gerald Zaltman, ninety-five percent of our thoughts, emotions and learning occur without our conscious awareness. And he’s not the only expert who thinks this way; the 95 percent rule is used by many neuroscientists to estimate subconscious brain activity.

Imagine for a moment that you had to do a deep, logical analysis of every little decision you had to make throughout the day, from what to wear to work to what to eat for lunch. You would never get anything done! Our entire lives would be consumed by assessing options and weighing pros and cons.

The human brain has been described by scientists as a “cognitive miser.” To allow us to live normal functioning lives, the brain has developed to preserve energy wherever possible. This is where the emotion – decision making connection comes in. The emotional side of our brain acts as a filter for many of our decisions. This doesn’t always lead to good decisions or rational decisions, but nonetheless emotions play a huge role in our decision-making process.

Think of it this way. The logical side of our brain (the rider) knows we should live a healthy lifestyle. It knows we should change our diet and exercise regularly. The emotional side (the elephant) wants to eat a bowl of ice cream. Which side usually wins out?

As you go through your day, think about all the decisions, both big and small, that you make. Give thought to how many of those decisions were made as a result of a logical decision-making process and how many were made merely because you “felt like it” in the moment. As mentioned above, these can be good or bad decisions. You may have “felt” like going for a jog, or you may have “felt” like eating a donut. The point is that the elephant is a lot more powerful than the rider.

For our purposes as healthcare providers, it’s very important to understand how people process decisions. Ultimately, the patient decides what to do with the information you provide, but when you connect with the emotional side of the patient’s brain (the elephant), you tip the scales in your favor that the patient will execute on the information you are providing.