We have 2 types of thinking systems

• Type 1 - Automatic affective system: Driven by feelings, habits, triggers in our environments
  • Rapid, requires little or no cognitive engagement
  • Based on emotional responses and response to “choice architecture”
  • Example: default options, information about others’ behaviour, cues outside awareness
• Type 2 - Reflective, goal-oriented system: Driven by our knowledge, values and intentions.
  • Engaged by traditional health promotion
  • Alter beliefs and attitudes, motivate people with the prospect of future benefits, or helps them develop self-regulatory skills
  • Takes more energy because it requires getting out of our habits

Metaphors

• Important to use the correct metaphor

The elephant metaphor

• Elephant = emotional mind -> biggest part
• Rider = Rational mind -> the rider is in charge
• Path -= environmental factors

The conscious car metaphor

• Feeling brain -> decides where we are going
• Thinking brain -> only gives comments

The professor and clown metaphor - the most correct metaphor

• The clown decides where we are going -> Emotions drive us
• The professor advises with the pros and cons of each decision -> Can be used in a state of calm

What do you do as a physiotherapist?

• As a physiotherapist, you need to become a behavioural engineer - a habit designer:
  • Create a path/environment that seduces the clown in you to do the desired behaviour and reduces temptation to do the undesired behaviour.
  • This is a more effective approach rather than just relying on motivation alone.
• It is important to remember that being insufficiently physically active is different than being sedentary
• In the 60s, the impact of sitting too long without interruption was compared to the effect of smoking in terms of health detriment and death.
  • This is not true, but it is still worthwhile for other outcomes (e.g., in terms of low back pain) to counter existing external social norms about sitting.