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Emergency Medicine News:
doi: 10.1097/01.EEM.0000397835.03892.23
Articles

Not Your Father's Intuition Anymore

Ballard, Dustin MD

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When you read the word “intuition,” what comes to mind?

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* A convenient excuse for acting on impulse.

* A skill molded by experience.

* The somatic marker hypothesis.

* Jamie Foxx's best-selling album about how to impress women.

If you answered “all of the above,” you are not only a student of the neural basis of cognition and Jamie Foxx's musical career but also absolutely correct.

Intuition is everywhere. It motivates a person to do something “because it feels right,” allows people to “follow their heart,” and gives justification to those who, like a certain former president, tend to “trust their gut feelings.” Each day, whether you realize it, you make many choices that are intuitive, ones that just seem to pop into your consciousness — effortless decision-making.

But what is the scientific explanation for intuition, and should intuition be trusted? The answer to the first question involves involuntary bodily responses (such as heart rate) linked to a series of brain connections called the X system. The answer to the second question has been much debated by neuroscientists. Interestingly enough, neither explanation references Jamie Foxx's thesis from the single Intuition Interlude: “I just know. It's just my intuition.”

Intuition is indeed multifaceted, and involves multiple areas and pathways of the brain, with romantic impulses processed differently from geometric guesses. Nonetheless, scientists are starting to identify distinct areas of the brain involved in intuitive knowledge. Functional MRI studies of self-knowledge, for example, demonstrate completely different areas of brain activation when someone speaks about something with which he has great experience (e.g., a soccer player discussing soccer) versus a topic about which he has only superficial knowledge (e.g., a soccer player talking about acting).

The areas of the brain triggered by experiential knowledge, which have been named the X system (for the ‘x’ in reflexive), also involve the mechanisms for affective cognition, known to most of us as feelings. Feelings often manifest themselves in bodily feedback, such as changes in heart rate and perspiration. This brings us to an area of debate called the somatic marker hypothesis. (Stay with me here; it sounds a lot more complicated than it actually is.) The somatic marker hypothesis proposes that people often “feel” intuitive knowledge through bodily changes before they are consciously aware of it. Strangely, the focus of the debate about this hypothesis has revolved around gambling.

In a recent study, Barnaby Dunn, PhD, of the Medical Research Council Cognition and Brain Services Unit in Cambridge, UK, and colleagues attempted to determine whether the generation and perception of involuntary bodily responses influenced people's decisions. (Psychol Sci 2010; 21[12]:1835.) The skill of perceiving bodily feedback is called interoception, and it's quite variable from person to person. (Quick: Without feeling your pulse, try to determine if your heart rate is at its normal speed.) What is also variable, according to Dr. Dunn, is how helpful the interoceptive skill is in assisting with decision-making.

His study recreated an experiment called the Iowa Gambling Task, which previously provided the basis for the somatic marker hypothesis. Volunteers wearing heart and perspiration monitors chose between four decks of cards; their choices had positive or negative monetary value. Without the volunteers' knowledge, two of the decks were profitable (60% payout rate), and two were not (40% payout rate). The researchers tracked decision-making success (picking from profitable decks) over time as well as changes in heart rate and perspiration (bodily feedback) and subjects' perception of such changes (interoception). Subjects who performed well went home with cash, albeit hamstrung by an un-Vegas-like maximum of $7 per person.

The study confirmed previous observations that bodily responses signal new knowledge (such as the identity of a profitable deck of cards) before someone is consciously aware of it. But the study also showed tremendous variability among individuals in the ability to perceive bodily signals and in the accuracy of those signals. As it turns out, intuition, like blond hair or artistic ability, is not equally distributed across the population. This means that people who seem to be lucky and whose hunches pay off may not be simply lucky after all. They have a skill like any other. For them, an appropriate mantra may just be “Intuit? Then just do it.”

I imagine the next area of investigation will be how to cultivate the skill of intuition. Clearly, experience helps a great deal. Professionals with years of experience make better reflexive decisions than those just learning a craft. But what about meditation, biofeedback therapy, and other methods used to access the innate and identify the subliminal? Is there a Rosetta Stone equivalent for intuition? Not that I am aware of. For the time being, try a daily dose of Jamie Foxx: “I know if it possess you. I know what you feel. You can't even fight it. It's just my intuition.”

I imagine the next area of investigation will be how to cultivate the skill of intuition. Clearly, experience helps a great deal. Professionals with years of experience make better reflexive decisions than those just learning a craft. But what about meditation, biofeedback therapy, and other methods used to access the innate and identify the subliminal? Is there a Rosetta Stone equivalent for intuition? Not that I am aware of. For the time being, try a daily dose of Jamie Foxx: “I know if it possess you. I know what you feel. You can't even fight it. It's just my intuition.”

Dr. Ballard is an associate emergency physician at Kaiser-Permanente in San Rafael, CA, and the chair of the CREST ED Research Network. His writing credits include co-authorship with Angela Ballard of the award-winning travel narrative A Blistered Kind of Love: One Couple's Trial by Trail (Mountaineers Books, 2003) and authorship of The Bullet's Yaw (IUniverse, 2007). Dr. Ballard writes a biweekly-medical column for the Marin Independent Journal, which he posts on his blog: http://incisionanddrainage.blogspot.com.

Comments about this article? Write to EMN at emn@lww.com.

© 2011 Lippincott Williams & Wilkins, Inc.

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