Intuition (Part 2 of 5)

Analyzing intuitive functions

There are layers of processes involved in intuition, including:

Automatic responses from previous experiences and memory

• • In seeking knowledge, the first step is silence, the second listening, the third remembering, the fourth practicing, and the fifth is teaching others.

• – Ibn Gabirol

When we learn a skill such as driving a car, we initially have to practice each component of turning on the engine, releasing the parking brake, putting the car in gear, steering as we step on the gas pedal, scanning for road clearance and hazards, braking, and so on. As we become proficient in all of these maneuvers, they become habitual and we can do them with little thought. Our automatic responses may be so good that we could be lost in thoughts and suddenly realize that we have driven some distance and cannot recall any conscious adjusting of the steering, braking, or other controls of the car.

The same processes of automating responses occur as we learn other skills, such as clinical medical and nursing interventions. Going through a medical history and examination is initially a complex process, involving myriads of details of information and procedures. The more experienced we are with these, the more they become automatic.

Clinicians are able to draw from their mental databases of knowledge in order to respond to situations rapidly and efficiently, often with little thought. Surgical bleeding occurs, and the surgeon instantly reaches for a clamp and stops it. The patient gags or retches, and the nurses’ hand is instantly reaching for the nearest handy towel or basin.

This is a basic level of intuition, in the sense of recognizing a problem and knowing what to do without having to consciously analyze the details and respond through conscious, logical deductions in order to respond to a situation.

Cognitive pattern recognition

Let us train our minds to desire what the situation demands.

– Seneca

A patient presents with depression, gravelly voice, and thick hair and the doctor, who hasn’t seen a case of hypothyroidism this severe since reading his medical school textbooks many years earlier, instantly recognizes that this is a case of hypothyroidism.

A surgeon asked me to see a 23 year-old patient after his appendectomy because he was depressed. His parents reported he had always been something of a loner. As I spoke with him, I felt uncomfortable because his eyes would not meet mine. The diagnosis of Asperger’s syndrome came to mind, from having seen children 5 to 10 years old with such presentations – particularly the avoidance of gaze.

Further questioning confirmed this to be a very likely diagnosis. I hesitated before sharing this impression, because it suggests an incurable problem, with the patient likely to remain autistic and distant from everyone. The parents, however, were extremely grateful because at last they understood their son’s problems and could plan how to deal with them.

Clinical pattern recognition may be more subtle. Clinical sensitivity often leads doctors, nurses, and other caregivers to recognize when something is going wrong or going well. Postoperative nurses will often report a sense of a patient “not being right,” although objective signs and symptoms are within normal limits. Often, these sorts of intuitive awarenesses prove correct, and an internal bleed or other problem develops soon after the nurse’s intuitive “alarm bells” start to ring. At other times, the nurse will sense that all is well, and the patient will have an uneventful postoperative course (King and Clark 2002).

Studies that consider the use of intuition in nurses with varying levels of experience confirm that this is a valid modality for decision making. These studies note a progressively greater development of trust in intuition – according to levels of experience, from nurses who are beginners, through those who are competent, proficient, and expert.

Pattern recognition appears to be (at least in part) an extension of learned knowledge, honed to a fine, automated tool. As clinicians learn more and become more experienced, they can perceive increasingly subtle patterns of appearance, behaviors, monitored body data (from sophisticated instruments), and laboratory studies which alert them to unusual changes and dangers in their patients.

This is the art and science of medical and psychiatric practice. It is medical detective work, the gathering of evidence and seeking the underlying pattern that explains the underlying dynamics (physical, psychological, spiritual) that solve the riddle of what caused the problems. Pattern recognition can this be a factor in intuitive awareness.

This level of intuition, pattern recognition, is congruent with the prevalent materialist paradigms that guide and inform conventional medical and nursing practice. Intuition, however, can reach far beyond this level.

Inspiration and creativity

When you are inspired by some great purpose, some extraordinary project, all your thoughts break their bonds; your mind transcends limitations, your consciousness expands in every direction, and you find yourself in a new, great and wonderful world. Dormant forces, faculties and talents become alive, and you discover yourself to be a greater person by far than you ever dreamed yourself to be.

– Patanjali (c. 1st to 3rd century BC)

Poets, writers, actors, painters, sculptors and others in the arts speak of inspiration that sparks their creativity. Inspiration may come as an idea in words. It is as though a voice speaks to them from another dimension, planting a new idea or a new way of perceiving or explaining something they are working on.

Many speak of a muse that has the feel of a wise entity with a distinct personality, visiting from some other dimension when they are quiet and receptive to its whisper. The muse may show them directly what is helpful or may speak through imagery – sometimes in dreams. Among those acknowledging such inspiration are poets A. E. Houseman, Longfellow, and John Masefield; authors Kipling, George Eliot, Oscar Wild; actor Sir Alec Guiness; musicians Stravinsky, Mozart, and Tchaikovsky; artists William Blake, Picasso, and Klee.

Scientists have acknowledged the help of a muse, including André Ampère, Karl Gauss, Henri Poincaré, Michael Faraday, Lord Kelvin, Albert Einstein, and Nikola Tesla. Thomas Edison, one of the most prolific inventors, reported that he found inspiration particularly in the dream-like state that is between waking and sleeping. Finding it was difficult to maintain this state, he would sit in a comfortable chair in the evening, holding a heavy metal spoon in each hand, resting his arms on the arms of the chair so that the spoons were suspended over metal pots on the floor. If he fell asleep, the clang of the falling spoon would bring him back to resume his receptive state.

This article appeared as the editorial in The International Journal of Healing and Caring – On line May, 2002, Volume 2, No. 2

(Continued in next column – Intuition Part 3)