Tag Archives: Emotions

The Core Requirement And Skill Of Decision-Making In Life – Removal Of Uncertainty Is Usually Positive And Cathartic But Is Also An Ephemeral Thing

This week, for the first time since moving to New Zealand and starting a new job here, I cycled in to work, and in the early afternoon faced a tough decision regarding whether I had the level of fitness capacity to cycle back home at the end of the day. Three-quarters of the way through the ride home, I felt very tired and stopped by the side of the road, and considered phoning home and asking them to pick me up. This morning I opened the fridge and had to decide whether to have the routine fruit and yogurt breakfast or the leftover piece of sausage roll. We have been six months in our new life and job here, and we have come to that period of time of deciding whether we have made a good decision and to continue, or whether we have made a disastrous error and need to make a rapid change. As I write this my wife asks me if I planned to go to the shop later, and if so whether I could get some milk for the family, and I had to stop writing and decide on whether I was indeed going to do so as part of the weekend post-writing chores, or not. All of these activities and issues required me to make decisions, and while some of them appeared to be of little consequence, some of them were potentially life and career changing, and, even if it seems a bit dramatic, potentially life-ending (whether to continue cycling when exhausted as a fifty-something). Decisions like these have to be made by everyone on a minute by minute basis as part of their routine daily life. The importance of decision-making in our daily lives, and how we make decisions, is still controversial and not well understood, which is surprising, given how much our optimal living condition and indeed survival depends on making correct decisions, and how often we have to make decisions, some of which are simple, some of which appear simple but are complex, and some of which are overtly complex.

Decision-making is defined as the cognitive process (which is the act or process of knowing or perceiving) resulting in the selection of a particular belief or course of action from several alternative possibilities, or as a problem-solving activity terminated by the genesis or arrival of a solution deemed to be satisfactory. At the heart of any decision-making is the requirement to choose between an array of different options, all of which usually have both positive and negative potential attributes and consequences, where one uses prior experience or a system of logical ‘steps’ to make the decision based on forecasting and scenario-setting for each possible alternative choice and consequence of choosing them. One of the best theoretical research articles on decision-making I have read / been involved with is one written by Dr Andy Renfree, an old colleague from the University of Worcester, and one of the Sport Science academic world’s most creative thinkers. As a systems level, he suggested that decisions are made based on either rational or heuristic principles, the former working best in ‘small world’ environments (in which the individual making the decision has absolute knowledge of all decision-related alternatives, consequences and probabilities), and the latter best in ‘large world’ environments (in which some relevant information is unknown or estimated). As described by Andy, rational decision-making is based on the principle that decisions can only be made if certain criteria are met, namely that the individuals making the decision must be faced with a set of behavioral alternatives and, importantly, information must be available for all possible alternatives of decisions that can be made, as well as of the statistical probability of all of the outcomes of the choices that can be made. This is obviously a large amount of requisite information, and a substantial period of time would be required to make a decision based on such ‘rational’ requirements. While using this method would likely be the most beneficial from a correct outcome perspective, it would also potentially place a high demand on the cognitive processes of the individual making the decision. Bayesian decision-making is a branch of rational decision-making theory, and suggests that decision-making is the result of unconscious probabilistic inferences. In Bayesian theory, a statistical approach to decision-making is made based on prior experience, with decision making valenced (and therefore speeded up) by applying a ‘bias’ towards information that is used to make the decision which is believed to be more ‘reliable’ than other information, and ‘probability’ of outcomes being better or worse based on prior experience. Therefore, in the Bayesian model, prior experience ‘speeds up’ decision making, though all information is still processed in this model.

In contrast, heuristic decision-making is a strategic method of making decisions, which ignores information that is available but is perceived to be less relevant to the specific decision being made, and which suggests that decisions are made based on key information and variables that are assessed and acted upon rapidly, in a manner that, as Andy suggests, incorporates ‘rule of thumb’ or ‘gut feel’ thinking, which places less demands on the cognitive thinking processes of the individual. As described above, rational decision-making may be more relevant in ‘small world’ environments, in which there are usually not a lot of variables or complexity which are required to be assessed prior to making a decision, and heuristic thinking in ‘large world’ environments, which are complex environments where all information, whether relevant or not, cannot be known, due to the presence not only of ‘known unknowns’ but also ‘unknown unknowns’, and where an individual would be potentially immobilized into a state of ‘cognitive paralysis’ if attempting to assess every option available. The problem or course is that even decisions that appear simple often have multiple layers of complexity that are not overt and of which the individual thinking about them is not aware, and it can be suggested that the concept of both rational and ‘small world’ environments are potentially abstract principles rather than reality, that all life occurs as part of ‘large world’ environments, and that heuristic processes are what are used by individuals as the main decision-making principles during all activities of daily living.

Of course, most folk would perceive that these rational and heuristic models are very computational and mathematical based, and that perhaps ‘feelings’ and ‘desires’ are also a component of decision-making, or at least these are how decision-making is perceived to ‘feel’ to them. As part of the Somatic Marker hypothesis, Antonio Damasio suggested that ‘body-loop’ associated emotional processes ‘guide’ (and have the potential to bias) decision-making behavior. In his theory, somatic markers are a specific ‘group of feelings’ in the body and are associated with specific emotions one perceives when confronted with, and are related to, the facts or choices one is faced with and need to make a decision about. There is suggested to be a different somatic marker for anxiety, enjoyment, or disgust, among other emotions, based on an aggregation of body-related symptoms for each, such as heart rate changes and the associated feeling of a pounding chest, the sensation of breathing changes, changes in body temperature, increased sweat rate, or the symptom of nausea, some or all of which together are part of a certain somatic marker group which creates the ‘feeling’ of a particular emotion. Each of these physiologically based body-loop ‘states’ are capable of being components of different somatic marker ‘groups’, which create the distinct ‘feelings’ which are associated with different emotions, and which would valence decisions differently depending on which somatic marker state / emotion is created by thinking of a specific option or choice. This hypothesis is based on earlier work by William James and colleagues more than a hundred years ago, which became the James-Lange theory of emotion, which suggests there is a ‘body-loop’ required for the ‘feeling’ of emotions in response to some external challenge, which is in turn required for decision-making processes related to the external challenge. The example used to explain this theory was that when one sees a snake, it creates a ‘body loop’ of raised heart rate, increased sweating, increased breath rate and the symptom of nausea, all of which in turn create the ‘feeling’ of fear once these ‘body-loop’ symptoms are perceived by the brain, and it was hypothesized that it is these body-generated feelings, rather than the sight of the snake itself, which induces both the feeling of fear and the decision to either rapidly run away or freeze and hope the snake moves away. While this model is contentious as it would make reactions occur slower than if a direct cognitive decision-making loop occurred, it does explain the concept of a ‘gut feel’ when decision-making. Related to this ‘body-loop’ theory, are other behavioral theories about decision-making, and it has been suggested that decisions are based on what the needs, preferences and values of an individual are, such as hunger, lust, thirst, fear, or moral viewpoint, but of course all of these could equally be described as components of either a rational or heuristic model, and psychological / emotional and cognitive / mathematical models of decision-making are surely not mutually exclusive conditions or theories.

These theories described above attempt to explain how and why we make decisions, but not what causes decisions to be right or wrong. Indeed, perhaps the most relevant issue to most folk is why they so often get decisions wrong. A simple reason may be that of ‘decision fatigue’, whereby the quality of decision-making deteriorates after a prolonged period of decision-making. In other words, one may simply ‘run out’ of the mental energy which is required to make sound decisions, perhaps due to ongoing changes in ‘somatic markers’ / body symptoms each time a decision is required to be made, which creates an energy cost that eventually ‘uses up’ mental energy (whatever mental energy is) over the period of time sequential decisions are required to be made. Astonishingly, judges working in court have been shown to make less favorable decisions as a court session progresses, and the number of favorable decisions improves after the judges have had a break. Apart from these data suggesting that one should ask for a court appearance early on in the morning or after a break, it also suggests that either physical or mental energy in these judges is finite, and ‘runs out’ with prolonged effort and the use of energy focusing on decision-making related to each case over the time period of a court session. There are other more subtle potential causes of poor-decision making. For example, confirmation bias occurs when folk selectively search for evidence that supports a certain decision that they ‘want’ to make, based on an inherent cognitive bias set in their mind by past events or upbringing, even if their ‘gut’ is telling them that it is the wrong decision. Cognitive inertia occurs when folk are unwilling to change their existing environment or thought patterns even when new evidence or circumstances suggest they should. People tend to remember more recent information and use it preferentially, or forget older information, even if the older information is potentially more valid. Repetition bias is caused by folk making decisions based on what they have been told, if it has been told to them by the greatest number of different people, and ‘groupthink’ is when peer pressure to conform to an opinion or group action causes the individual to make decisions they would not do if they were alone and not in the group. An ‘illusion of control’ in decision-making occurs where people have a tendency to under-estimate uncertainty because of a belief that they have more control over events that they actually have. While folk with anxiety tend to make either very conservative or paradoxically very rash decisions, sociopaths, who are thought to have little or no emotional ‘body-loop’, are very poor at making moral based decisions or judgments. Therefore, there are a whole lot of different factors which can impact negatively on decision-making, either due to one’s upbringing or prior history impacting on the historical memory which is used to valence decisions, or due to one’s current emotional or psychological state having a negative impact on decision-making capacity, and even simple fatigue can be the root cause of poor decision-making.

At the heart of decision-making (excusing the pun, from the perspective of the somatic marker hypothesis), is a desire of most folk to remove uncertainty from their lives, or change their life or situation to a better state or place as a result of their decision, or to remove a stressor from their life that will continue unless they make a decision on how to resolve it, remove it, or remove themselves from whatever causes the stressor. However, during my days as a researcher at the University of Cape Town, we suggested that conditions of uncertainty and certainty associated with information processing and decision-making are cyclical (we called it the ‘quantal packet’ information processing theory, for those interested). A chosen decision will change a position or state of uncertainty to one of certainty as one enacts changes based on the decision (or if one chooses to ‘wait and see’ and not alter anything) from the context that one is certain a change will occur based on what one has decided to do, even if one cannot be sure if this difference will be positive or negative while the changes are being enacted. However, with the passing of time, the effects of the decision made will attenuate, and uncertainty will eventually re-occur which require a further decision to be made, often with similar choices to which occurred when the initial decision was made. Underpinning this attenuation of the period of ‘certainty’ is the concept that although one will have factored in ‘known unknowns’ into any decision one makes using either rational or heuristic principles, ‘unknown unknowns’ will surely always occur that will cause even the best strategic decisions to require tactical adjustments, and those that are proven to be an error will need to be reviewed and changed. One can also ‘over-think’ decision-making as much as one can ‘under-think’ it, as well as being kept ‘hostage’ to cognitive biases from one’s past which continuously ‘trip one up’ when making decisions, despite one’s best intentions. Having said all of this, it often astonishes me not that folk get decisions wrong, but rather that they get so many decisions right. For example, when driving along a highway, one is reliant on the correct decisions of every driver that passes for one’s survival, from how much they choose to turn their steering wheel, to how much they use their brake for a corner, to an awareness in each of them that they are not too tired to be driving in the first place. It’s amazing when one thinks of how many decisions we make, either consciously or unconsciously, which so often turn out right, but equally it is the responsibility of each of us to work on the errors created by our past, or by our emotional state, or by ‘groupthink’, which we need to be vigilant about and remove as best possible from the psyche.

Making a decision is usually cathartic due to the removal of uncertainty and the associated anxiety which uncertainty often causes, even if the certainty and feeling of goodwill generated by making a decision is usually ephemeral and lasts only for a short period of time before other matters occupy one’s attention which require further decision-making. Pondering on my decision-making of the last week retrospectively, I think I made the right decision when choosing to cycle home after work, and to do so all the way home, even if I was exhausted when I got there, given that I did not collapse or have a heart attack when doing so, and there will surely be long term health benefits from two long cycles (though of course long is relative at my age!) in one day. I did choose the healthy food alternative for breakfast this morning, even though often I don’t, particularly during meals when I am tired after a long day’s work. I will get the milk my wife asked me to get this afternoon, in order to both get some fresh air after a creative morning of thinking and writing, and to maintain the harmony in our house and life, even though it is raining hard and I would prefer to be writing more or reading a good book this afternoon. The ‘jury is still out’ about whether this move to New Zealand and a new work role has been a good career and country move, and my current decision on this is to let more time pass before making an action-generating reasoned decision on it, though of course we have already moved several times to new places round the world in the last two decades, and the family is looking forward to some lifestyle stability in the next few years, and these factors need to be part of any reflection on a current-environment rating decision. Each of these decisions seemed ostensibly relatively simple to make when I made them, yet each surely had an associated entire host of different reasons, experiences, memories and requirements which were worked through in and by my mind before making them, as will be so for all folk making decisions on all aspects of their life during a routine day. What will I have for lunch now I am finished writing this and am now tired and in need of a break and sustenance? Perhaps I will leave off that decision and relax for a period of time before making lunch-related choices, so as not to make a fatigue-induced bad decision, and reach for that sausage roll, which still is in the fridge. And I need to get going and enact that decision I made to get the milk, and head off to the shops in order to do so as soon as possible, before lethargy set in and I change my mind, otherwise I will surely be in the ‘dog box’ at home later this afternoon, and my sense of cathartic peace resulting from having made these decisions will be even more ephemeral than usual!

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The Sensation Of Fatigue – A Complex Emotion Which Is Vital For Human Survival

After a couple of weeks back at work after a great Christmas season break, I have noticed this week a greater than normal level of fatigue than I normally ‘feel’ at the end of a routine working week. After one of the hottest December months on record in my current home town, where temperatures for a while were consistently hovering around forty degrees Celsius, we have had a wonderful rainy, cool period, and I have noticed that I feel less fatigued in the cooler environment, and routine daily activities seem ‘easier’ to perform than when it was excessively hot. As part of a New Year’s resolution ‘action plan’ to improve my level of fitness, I have increased my level of endurance exercise, and as always have enjoyed the sensation of fatigue I feel towards the end of each long (though I know that ‘long’ is relative when compared to younger, more fitter folk) bike ride I do as part of this ‘fitness’ goal. All of these got me thinking of the sensation of fatigue, an emotional construct which I spent a great many years of my research career trying to understand, and which still is very difficult to define, let alone work out its origins and mechanisms of elicitation in our physical body structures and mental brain functions.

As described in these three very different examples from my own life, fatigue is experienced by all folk on a regular basis in a variety of different conditions and activities. Perhaps because of this, there are many different definitions of fatigue. In clinical medicine practice, fatigue is defined as a debilitating consequence of a number of different systemic diseases (or paradoxically the treatment by a variety of different drugs) or nutritional deficits. In exercise physiology, fatigue is defined as an acute impairment of exercise performance, which leads to an eventual inability to produce maximal force output as a consequence of metabolite accumulate or substrate depletion. In neurophysiology, fatigue is defined as a reduction of motor command from the brain to the active muscles resulting in a decrease in force or tension as part of a planned homeostatic process to prevent the body from damage which could result from too high a level of activity or too prolonged activity. In psychology, fatigue is defined as an emotional construct – a conscious ‘sensation’ generated by the cognitive appraisal of changing body or brain physiological activity which is influenced by the social environment in which the activity changes occur, and the mood status, temperament and background of the person ‘feeling’ these physiological changes. It will be evident from all of these different definitions how complex fatigue is an ‘entity’ / functional process, and how hard it is for even experts in the field to describe to someone asking about it what fatigue is, let alone understand it from a research perspective.

A number of different physical factors have been related to the development of the sensation of fatigue we all ‘feel’ during our daily life. During physical activity, it has been proposed that changes in the body related to the increased requirements of the physical exertion being performed cause the sensation of fatigue to ‘arise’. These include increased heart rate, increased respiratory rate, increased acid ‘build up’ in the muscles, reduced blood glucose or muscle or liver glycogen, or temperature changes in the body, particularly increased heat build-up – though for each study that shows one of these factors is ‘causal’ of the sensation of fatigue, one can find a study that shows that each of these specific factors is not related to the development of the sensation of fatigue. It has also been proposed that changes in the concentration of substrates in the brain structures associated with physical or mental activity are related to the sensation of fatigue – such as changes in neurotransmitter levels (for example serotonin, acetylcholine, glutamate), or changes in the nutrients supplied to the brain such as glucose, lactate or branched chain amino acids. But, again, for each study whose findings support these hypotheses, there are studies that refute such suggestions. It has also been suggested that a composite ‘aggregation’ of changes in all these body and brain factors may result in the development of the sensation of fatigue, via some brain process or function that ‘valences’ each in a fatigue ‘algorithm’, or via intermediate sensations such as the sensation of breathlessness associated with increased ventilation, the sensation of a ‘pounding’ heart from cardiac output increases, the sensation of being hot and sticky and sweating which result from temperature increases in the body, and / or the sensation of pain in muscles working hard, all of which are themselves ‘aggregated’ by brain structures or mental functions to create the complex sensation we know and describe as fatigue.

Which physical brain structures are involved in the creation of the sensation of fatigue is still not known, and given the complexity of the factors involved in its generation, as described above, large areas of the brain and a number of different brain systems are likely to be involved – the motor cortex as muscle activity is often involved, the sensory cortex as signals from changes in activity in numerous body ‘parts’ and functions are ‘picked up’ and assimilated by the brain, the frontal cortex as cognitive decision making on the validity of these changes and the need for potential changes in activity as a result of this ‘awareness’ of a changed state is required, the hippocampus / amygdala region as the current changes in physiological or mental activity must be ‘valenced’ against prior memories of similar changes in the past in order to make valid ‘sense’ of them as they currently occur, and the brainstem as this is the area where ventilation, heart function and a variety of other ‘basic’ life maintaining functions are primarily controlled, for example, amongst many other potential brain areas. We don’t know how the function of different brain areas is ‘integrated’ to give us the conscious ‘whole’ sensation we ‘feel’, and until we do so, it is difficult to understand how the physical brain structures ‘create’ the sensation of fatigue, let alone the ‘feeling’ of it.

How the mental ‘feeling’ of fatigue is related to these physical body and brain change ‘states’ is also challenging for us research folk to understand. Clearly some ‘change’ in structures, baseline physical values or mental states by whatever induces the fatigue process, be it physical or mental exertion or illness, is required for us to ‘sense’ these and for our brain and mental functions to ‘ascribe’ the sensation of fatigue to these changed states. It has previously been shown that the sensation of fatigue which arises during exercise is related to the distance to be covered, and increases as one gets closer to the finish line. While this sounds obvious, as one would expect the body to become more ‘changed’ as one exercises for a longer period, it has been shown that when folk run at the same pace for either five or ten kilometres, despite their pace being identical in both, at the 4km mark in the 5 km race the rating these folk give for the sensation of fatigue is higher than it is at 4km of the 10 km race, which is ‘impossible’ to explain physiologically, and suggests that folk ‘set’ their perceptual apparatus differently for the 5 and 10 km race, based on how far they have to go (what H-V Ulmer described as teleoanticipation), by changing the ‘gain’ of the relationship between the signals they get from their body depending on how far they plan to go. Two great South African scientists, Professor Ross Tucker of the University of Free State, and Dr Jeroen Swart of the University of Cape Town, have expanded on this by suggesting that there is a perceptual ‘template’ for the sensation of fatigue in the brain, and the sensation of fatigue is ‘created’ in an organized, pre-emptive ‘way’ by mental / cognitive processes in the brain, and the sensation of fatigue is ‘controlled’ by this template depending on the distance and / or duration of a sporting event. If something unexpected happens during an event, like a sudden drop in temperature, or a competitor that goes faster than expected, this will create an unexpected ‘change’ in signals from the body and requirements of the race, and the sensation of fatigue will become more pronounced and greater than what is expected at that point in the race, and one will slow down, or change plans accordingly. Ross and Jeroen’s fascinating work show how complex the mental component of the sensation of fatigue and its ‘creation’ by brain structures is.

There are multiple other factors which are involved in the generation of the sensation of fatigue, or of its modulation. I did my medical PhD (an MD) on chronic fatigue syndrome which developed in athletes who pushed themselves too hard until they eventually physically ‘broke down’ and developed the classical fatigue symptoms associated with chronic fatigue, where they felt fatigue even when not exercising, which was not relieved by prolonged periods of rest. These athletes clearly pushed themselves ‘through’ their fatigue symptoms on a regular basis until they damaged themselves. As one of the pioneer and world-leading experts in the fatigue field, Professor Sam Marcora, has pointed out, one’s ambitions and drives and ‘desire for success’ are a strong indicator both of the level of the symptom of fatigue folk will ‘feel’, and how they resist these symptoms. In these chronically fatigued folk we studied, something in their psychological makeup induced them either to constantly continue exercising despite the symptoms of fatigue, or made them ‘feel’ less sensations of fatigue for the same work-rate (assuming their fitness levels and physical capacity was similar) to most folk who do not experience this syndrome (the vast majority of folk). To make the matter even more complex, these folk with chronic fatigue described severe sensations of fatigue at rest, but when we put them on a treadmill, some of them paradoxically felt less, rather than more, sensations of fatigue when running as compared to resting, and their extreme sensations of fatigue returned (to an even greater degree) in the rest period after they completed the running bout. Furthermore, if one gives stimulants to folk when they exercise, such as caffeine, it appears to reduce the ‘awareness’ of the sensations of fatigue. Sam is doing some interesting work currently looking at the effect of caffeine on attenuating the sensation of fatigue – as did Dr Angus Hunter several years ago – and thereby using it as a ‘tool’ to get folk to exercise more ‘easily’ as they appear to ‘feel’ fatigue less after ingesting caffeine. All this shows again that the sensation of fatigue is both a very complex emotion, and a very ‘labile’ one at that, and can change, and be changed, by both external factors such as these stimulants, and internal factors such as one’s drive or ‘desire’ to resist the sensation of fatigue as they arise, or even ‘block them out’ before they are consciously generated. More research, and very advanced research techniques, will be required for us to clearly understand how and such potential ‘blockages’ of the sensation of fatigue happen, if they indeed occur.

The sensation of fatigue is therefore an immensely complex ‘derivative’ of a number of functions, behaviours, and psychological ‘filters’, and what we finally ‘feel’ as fatigue is ‘more’ than a simple one-to-one description of some underlying change in our physical body and brain that requires adjustment or attenuation. The sensation of fatigue is clearly a protective phenomenon designed to slow us down when we are exercising too hard or too long in a manner that may damage our body, or when we are working too hard or too long and need a ‘time out’, or when the environment one is performing activities of daily living in may be harming one. But there are usually more complex relationships and reasons for the occurrence of the sensation of fatigue than what on the surface may appear to be the case. For example, the increase in work related fatigue I feel is surely related not just to the fact that it is the end of a busy week – it is perhaps likely to be related to a ‘deep’ yearning to be back on holiday, or to the fact that my mind is not ‘hardened’ yet to my routine daily work requirements, or has been ‘softened’ by the holiday period so that now I feel fatigue ‘more’ than is usual. In a few weeks time this will surely be attenuated as the year progresses and my weekly routines, which have been ‘honed’ over many years of work, are re-established, and I will feel the ‘usual’ rather than excessive symptoms of fatigue as always on Thursdays and Fridays. The extreme feeling of fatigue I felt during the very hot December month may also be related to some subconscious ‘perception’ that my current living environment is perhaps not optimal for me lifestyle wise for a long term living basis, and this ‘valenced’ how I perceived the environment as one of extreme heat and therefore extreme (and greater than expected) fatigue last month. And that I am ‘enjoying’ the sensations of fatigue I feel when exercising may mean that I am perhaps not pushing my exercise bouts as hard as I could, and need to go harder, or that my mind and body is setting a pace that feels enjoyable both so I continue doing it, or to protect me from a potential heart attack if I go harder. All of these may be the case, or equally, all of these could be mere speculation – the science folk in the area of fatigue have a big mountain to climb, and many more hours in the lab, before we more fully understand the complex emotion which the sensation of fatigue is, and how and from where it arises and is controlled.

A time may come when Sam Marcora and other excellent research colleagues like him find the ‘magic bullet’ that will ‘banish’ the sensation of fatigue, and we will be able to work harder and exercise longer because of it. But then would the cold drink after exercise taste so good, or the feeling of accomplishment one gets at the end of a long exercise bout as a result of resisting the sensation of fatigue long enough to achieve one’s goals for the particular exercise bout one has just completed still occur? This is something to ponder on, when fatigued, as I am now after two hours of writing, as I sip my cup of coffee, and wait for my ‘energy’ to return so I can begin the next task of a routine Sunday, whether it be cycling with the kids, walking the dog, or any other fatigue-removing activity as I prepare for the next fatiguing cycle which is the work and sport week ahead!


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