Diagnosis: Anchoring

“But Dr. Day, I think there’s something wrong” Mrs. L says, with a pang of concern. “I do agree there is something wrong; I think your anxiety is getting the better of you” I reply, trying to provide reassurance.

I have been seeing Mrs. L now for a few years and every visit it’s more or less the same story — she tells me about her variety of vague, poorly differentiated symptoms that come and go and lead to her “not feeling well”.

My impression is that it’s always the same — a physical manifestation of her anxiety. It’s getting to the point where I make my mind up before our visit is even complete that it’s just her anxiety.

But what if one day it isn’t? What if one day she has a serious medical illness — like cancer, for example — and I write it off as just her anxiety. This would obviously be a massive problem, one that both of us would like to avoid.

Thinking about this further, my mind goes to the story of the boy who cried wolf. I think to myself “well, if she doesn’t want that to happen, she should stop crying wolf”. As a knowledge worker and healer, is this line of thought really helpful? What is really going on in my mind?

In essence I am anchoring — I am using the first impressions of Mrs. L as a basis for my future decision making. This phenomenon, which was first described by social psychologist Muzafer Sherif in 1958, is pervasive through out multiple domains in our life.

Buy an item on sale and feel like you got a great deal, based on the difference from the regular price? Anchoring.

Comparing the enjoyment of a movie sequel to the original film? Anchoring.

Have an investment you want to part ways with, but won’t sell until you have broken even? Anchoring.

Wonder why your second child’s behaviour is so different compared to your first? Anchoring

See Mrs. L and always just think she’s anxious? Anchoring.

Anchoring is nearly impossible to avoid, so what’s a reflective physician to do?

In addition to being mindful when it is happening, I think the biggest thing is to avoid rushing a decision under pressure and to let it percolate in my mind, This way my more deliberate, thoughtful cognitive mechanisms to digest it.

I’m sure Mrs. L would appreciate this thoughtfulness and me not being so quick to label her as well.