After my children were born I was very surprised by the degree to which emotional rather than rational thinking influenced our parenting decisions. Even simple choices seemed complicated: Should we
wake the baby to feed or allow her to sleep? Was the injury risk from contact
sports greater than the benefits of team play? Should the kids stay home when
they have a cold but miss their math test? Were we setting boundaries that were too
strict or not strict enough? The list was endless and intuition quickly earned
a prominent place in our parenting tool kit. We came to realize that there was simply no other
practical way to make these choices.
The concept of intuition is quite
mysterious. We understand that it is not rational and use vague descriptive
terms like “gut feeling” and “sixth sense” but we don’t quite understand how
intuitive feelings get into our heads in the first place. Even more
disquieting is the notion that we have to use intuition to know when to trust
our intuition. Intuitive thoughts allow us to make predictions that might seem
to be based on absolutely nothing, but the most valuable intuitions occur when we unconsciously compare
past experience to what is happening in the present. They can warn us away from
serious danger, “I don’t want my daughter travelling in that boy’s car,” and
they can address the more trivial concerns of a mother who asks through the
bathroom door, “Are you okay in there?” Despite its limitations, most of
us agree that a parent’s intuition has real value and it is easy to recall
situations where potentially terrible mistakes were prevented by responding to a seemingly
unexplained anxiety. It is quite possible, however, that we exaggerate its accuracy and minimize its
failures because we are more likely to remember those times when we discovered
a toddler about to drink furniture polish than when we rushed to the kitchen
and found our child happy and safe.
There is usually a complimentary
relationship between intuitive and rational thought. But when there
isn’t, bad things can happen.:When rational thinking tells us one thing and
intuition another, parents can become so immobilized that they can't
make any decisions at all. And there are times when parents were absolutely
certain that something is true but intuition tells them to ignore it
anyway. It is counterintuitive, but very confident parents who believe that “no one
knows my child better than I do,” are at extra risk for making mistakes because
they are so certain they know what will happen next.
Group
intuition can also lead us astray. Most recently, it is playing a role in vaccine refusal. Vaccinating against infectious disease is one
of the few times a parent can knowingly lessen their child’s chance of
developing permanent brain damage and even death. But the strong power of
negative intuition might cause a parent to delay or miss this opportunity -
especially when it is reinforced by like-minded friends, relatives and pundits.
The statistical evidence is very clear that the risk of developing brain inflammation from measles illness is one thousand times greater than
from the vaccine: One per thousand vs one per million. Even when we exclude
parents whose religious beliefs don’t allow vaccination and those who think
that vaccination is a conspiratorial plot, we might reasonably wonder why an
informed parent would hesitate to vaccinate against this disease. The answer is
that a fairly large group (including some parents who did vaccinate their
children) have a strong intuitive feeling that it is the wrong thing to
do. They are aware of the benefits and the risks to their child and others,
but it just doesn't feel right. Some have
understandable but irrational concerns about giving too many shots, tinkering
with the immune system, injecting a "foreign" substance, or the
discredited association between vaccines and autism. Often, they will not or cannot articulate why they are so wary. But once this feeling of
dread has been planted in their heads, a rational discussion with the doctor is
unlikely to make it go away. Unfortunately, we pediatricians can be part of the
problem. We often tell parents to trust their intuition but then we don’t address their non-rational fears in a respectful or meaningful way.
We can and should agree with parents that their iintuition is a very powerful tool ,but then we can offer them some additional advice: First, be certain that the information
you are relying on is current and comes from a reliable source. Be especially wary of
“junk science,” anecdotes, and unsubstantiated claims that are found on the
internet. Next, try to keep rational thinking and intuitive thinking separate. Don't try to rationalize one in terms of the other; we will make better decisions once we can say, “I know that the evidence says
this, but my intuition tells me that…,” Third, get another opinion – preferably
from the child’s other parent. In the vaccine example, I was surprised to learn
how often parents in stable relationships have never discussed this issue with
each other. (That is why I frequently made both parents sign our refusal to vaccinate form; it is not legally necessary but it forces both parents to have a conversation.). And last, suggest that they give more weight to the best available information
and rational thinking when making those decisions that are most important; vaccination is one of them. Life
events are unpredictable, but over time, we are more likely to guess right by
playing known odds than by betting on a hunch.
