What happens if any new information contradicts our previous assumptions?
We need to hear it three times!

Why is that?
We desperately cling to our creation of the world!
Our brains do not register the world as it is, they are constantly filtering out and adjusting the information we take in.

As I have described before, “Nobody sees the world like you do!”.
Another aspect I have mentioned before is the fact, that we really do not like to be contradicted. This triggers the feeling of cognitive dissonance, and we try all to avoid this strong emotion. We will aim to shut down, to not listen because we try to preserve the world we have created in our minds.

What are the implications?

When the world of our patients “world” falls apart, for example due to an illness, they would love for someone, to just tinker at the edges. They long for someone to make it “work” again, without facing the possibility, that their basic assumptions might be wrong. This would be part of the inner storyline of the parent and the child.

Now we, as the doctor, enter the room and have to “break bad news”, things have to change.

I described before how important the whole concept of change is in the whole treatment journey.

But let me focus on another, very basic aspect first: Everything we hear, that is in line with our expectations, we only need to hear once to take it in.

Everything that goes against our assumptions, needs to be repeated three times for us to “hear” it once.

So we have to hear it three times!

Why is that?

Our brains try to actively filter out, what contradicts our basic assumptions.

Do I have any proof for this?

In the movie “Good Will Hunting” the maths Professor Gerald Lambeauenters a mentorship with Will Hunting and organizes psychotherapy for him. In one scene, the psychotherapist tells Will, that his foster father’s abusive behaviour was not his fault. He says it once, and Will replies dismissively: “yes, I know”.  The psychotherapist repeats a second time, and again Will dismisses the statement quickly with “yes, I know”. The third time, the psychotherapist insists on looking Will into the eyes and repeats again “it was not your fault”. Now Will breaks down crying because only this third time, the words have hit home, and he heard the release from his inner accusations.

We need to hear it three times!

What is the importance of this?

Doctors are notoriously short on time. We try to use any shortcut to transfer information to our patients and their parents that we can find. However, throwing information at them and hoping that something will stick is not really an efficient way of using our time.

We would need to identify, where they come from, what barriers of communication would have to be conquered. After this, our role would be to adjust and present the information they must receive in a way, that they actually can hear it. They have to hear it three times!

In a nutshell:

Anything that contradicts our assumptions about the world, needs to be repeated three times, for us to hear this once!

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Different concepts of reality

The backdrop of change: Cognitive dissonance