Too Little Info = Biased Conclusions About Disability

Lynn Murray’s pre-injury self would not be able to make sense of his post-injury self flying an ultralight glider.

Lynn Murray’s pre-injury self would not be able to make sense of his post-injury self flying an ultralight glider.

I ran across a new term the other day — availability heuristic. It has a heady ring to it, so I figured I’d better check it out. In the Psychology section of About.com, Kendra Cherry writes:

“An availability heuristic is a mental shortcut that relies on immediate examples that come to mind. When you are trying to make a decision, a number of related events or situations might immediately spring to the forefront of your thoughts. As a result, you might judge that those events are more frequent and possible than others. You give greater credence to this information and tend to overestimate the probability and likelihood of similar things happening in the future.” (psychology.about.com/od/aindex/g/availability-heuristic.htm)

In shorthand, too little info leads to mistaken preconceptions.

Let me back up a little and see if I can explain how this idea plays into the topic of disability.

As a “walkie” years ago, I had taken steps to avoid persons in wheelchairs. They looked different. They acted differently. (How do they take a leak?) And they made me uncomfortable. So, I simply eliminated opportunities to become uneasy — I avoided them like the plague.

Then, I went off a roof and landed in a chair. I joined the club.

A couple years post-SCI, my wife and I attended the Abilities Expo in Anaheim, Calif. For a newbie, it was an eye-opener in many ways. For example, during my rehab stint, there didn’t happen to be any quads on the floor, and as a T6 para, I didn’t really know what they were about. Then, in Anaheim, a guy came rolling down the aisle in this monster chair. I’d never seen anything like it. (Remember, I was a newbie who unwittingly used “availability heuristic” to define many things.) This guy was shaved smooth as a cue ball — one that was out of round. About a quarter of his skull was gone. He was trached and using one of those sip-and-puff systems I’d only heard about. On top of that, he had this nasty scar that ran diagonally the length of his face. I stopped there in the middle of the aisle and just stared. He powered on by and gave me this wicked grin. I felt like crap. I crawled inside myself and did the best I could to peruse the booths in a different part of the expo.

Sadly, that guy became my frame of reference when I heard the word quad. “Availability heuristic” had kicked in and my shortcut definition was way wrong.

Cherry missed one thing in her explanation: the fact that negative memories carry more weight than positive ones. Clifford Nass, professor of communications at Stanford University, says this: “The brain handles positive and negative information in different hemispheres.” Negative emotions generally involve more thinking, and the information is processed more thoroughly than positive ones, he says. Thus, we tend to ruminate more about unpleasant events — and use stronger words to describe them — than happy ones (from “Praise is Fleeting, but Brickbats We Recall” by Alina Tugend, Your Money, The New York Times [Mar 23, 2012]).

In other words, we use negative shortcuts more often than positive ones.

I’ve thought a lot about that. About the way we use shortcuts to define things. About how often those definitions are inaccurate. And how — despite their inaccuracy — they continue being used like they came right out of Merriam-Webster. To top it off, the psychologists seem to say we’re almost powerless to avoid using them.

Let’s try an experiment: What do you think of when you hear the words “plane crash?” Do we think of a Cessna 172 putt-puttin’ down the taxi lane and — oops — veering onto the shoulder, digging in (it rained) and nearly dipping a wing? Of course not. We think of events like a 747 sucking a few dozen geese into the turbines, hitting a wind sheer and smacking into the side of a mountain, killing 200 people.

Wait a second. We were defining a “plane crash,” not a “freak airline-goose encounter with catastrophic consequences.” Why did we go to the big disaster instead of the little one? Simple. Because in this instance our minds have adopted the more negative example — the one that has left the most dramatic image in our memories. Do we remember the newspaper photo of a Cessna with the nose wheel in the sod? Or do we remember the photo of the debris spread across the snow-covered peak?

Yep. That’s what I thought.

Over time and after expending a healthy dose of mental energy, I managed to correct my definition of a quad. But I have to tell you, for the longest time the word conjured up the image of the guy I saw at the expo.

The Need for Educational Advocacy
I volunteer for a little mobility support group and recently became acquainted with a young man who’s a C6 quad. Get this — he can walk! Not much, of course, and it looks pretty funky. But, he can walk. Between the two of these guys, my availability heuristic definition got blown out of the saddle.

I was 59 when I went off the roof, so I’d spent most of my life on my feet. I’d fought forest fires, done some alpine climbing, coached high school football and worked concrete, among other things. So, throughout my adult years, I’d accumulated a bunch of definitions — shortcuts — with which to better MISunderstand things. And, looking back, a bunch of those misunderstandings could result in an unhappy life. Misunderstandings about things like honesty, integrity, the milk-of-human-kindness, and all that jazz.

People have asked me if I’d like to go back — be a “walkie” again. And without hesitation, I answer, “Nope.” I have learned a lot about who and what I am, and who I was. I’ve also learned to watch out for the quick response to a complicated question.

There’s another chapter to this story that has to do with the availability heuristic principle and the general public’s perception of disability.

At the Roll On Capitol Hill in August 2013, president and CEO of United Spinal Association, Paul Tobin, told of an event in which members of Congress were asked, “What’s the first thing that comes to your mind when you hear the word, disabled?” In this order, the most prevalent responses were: fraud, liability and lawsuits. No reference to sight, hearing or mobility impairment, to chronic disease or mental disorder. Only to criminal behavior and money. Hmmm.

As a card-carrying crip, that ticks me off on multiple levels — the worst of which is being called a liar and a cheat; and the implication that all wheelchair users are liars, as well as their physicians, PTs, OTs, ATPs and DME providers.

The general public’s availability heuristic — their shortcut — has been framed by the late-night Scooter Store commercials (“you won’t pay a dime for one of these”), by the war stories they’d heard about Medicare abuses and by a media grabbing at sensational headlines. The real tragedy here is not merely the inaccuracy. The real tragedy is what happens when persons in power are misinformed, uneducated or purposefully avoid spending the effort to learn the truth. Their decisions can have far-reaching effect. And, when those decisions are wrong?

Case in point — complex rehab technology. You’ve heard the song, “A chair is a chair is a chair.” This mindset leads to the conclusion that the chair I was rolling in at the Abilities Expo was the same as the chair that quad dude was using. Right. After all, each of us was sitting down while moving about. Same needs — to sit and roll; therefore, same equipment.

I won’t waste your time with the obvious fallacies. Regardless, the general public is ignorant of the reality that distinctly different needs demand distinctly different equipment. Add insurance abuses to that and you get the Medicare notion that all paras and many quads need only a 36-pound K0001 manual wheelchair (or facsimile).

This availability heuristic thing has a lot of power, especially when it’s exercised without our even knowing it. Granted, the politicians who were presented with the above question were all budget-minded Republicans, but — party politics aside — we all have blind spots, which is where the education element of advocacy becomes so vital. We don’t know about our biases until someone strips us down and forces us to look in the mirror.

Seeing things the wrong way — intentionally or not — exacerbates the one characteristic that we humans all share: ignorance. Not a pleasant feature when you use reactions to the word disabled as an example. Blind spots, bias, prejudice, misinformation, mob mentality. It doesn’t matter what you call it, why or how it got there. It sucks.

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