"I Trust My Gut"

I recall reading descriptions on what percentage of people form their opinions by trusting authority versus subjective impression versus social aspiration and a few others. I don't remember whether I have ever been convinced by the measurements of any such reports, as they were likely questionnaires. But I get the general idea, and there is something to it. We observe others who readily accept what important people tell them, while others rely heavily on their impressions of people and situations, and third/fourth/fifth groups gravitate to what ideas the Best People have, or trying to see behind motives. We all think we are being logical, sure, and some of us are. Yet we all have tendencies.

The greater density of connections between the two sides of the brain in women has been offered as an explanation of women's intuition. Men are tracking a more limited number of paths, but they can identify them and explain them.  Women are drawing on more data but have trouble identifying exactly where the reasoning comes from. It's a tidy explanation, and may even have some truth to it.  I know men who are certain that their wives can see through others better than they do and rely on their opinions of whether to trust people or not.

I have trust in the long-term experience of others, and early in my career was fascinated by clinicians who would say out loud "I've learned to trust my gut on these things. I think he's lying." It was a conflict for me because it didn't sound like reasoning to a clinical decision, but I did respect that these clinicians had much more training and experience, and others in the room would nod supportively when they said this. I supposed it could be true, an alternate way of evaluating that I just didn't understand all that well. I paid attention. I noticed there were others who didn't use those words but seemed to be arriving at opinions in similar ways. I still think there might be something to it.

But I came to reject and even fear it over time when it dropped from the lips of a person who had power over a patient, because I saw it go wrong.  An early case I still regret not seeing more clearly. A young man had been brought in through an unusual backchannel, mostly on the testimony of his wife, who was divorcing him. She reported he had abused her and the children and had made strange sexual statements about them. He now had a no-contact order and could not see her or them. He was pleasant but quiet, denying everything, only occasionally seeming to get irritated when describing the situation. He was too calm. He pointed out he had a responsible job, volunteered with the Boy Scouts, and had a church he went to that his wife had decided she didn't like.  

The team leaders, middle-aged social worker and best friend charge nurse both spoke with him quite a bit over the next week.  I did not, and the case was only mine part-time anyway. We were coming up to a decision point whether we should release him. He had not said or done anything dangerous at the hospital. His wife had called various people at the hospital to tell us how dangerous he was and to please not release him. He had not authorised us to give her information, but the team leaders decided they could listen and ask questions. That second part is now expressly forbidden, but was only frowned upon then. It is easy to see how one could give lots of information away with the questions one chose to ask. 

"We" decided to try and hold him and filled out the petition, but the hospital attorney sent it back, saying there was nothing to bring to court. Our clinicians shook their heads. "I really think he's dangerous.  I trust my gut on things like this.  There's something about him that's just not right." 

I had known him slightly in childhood, and mentioned that he had always been quiet. He was seen as odd, overly focused on small details of things. Well, that sealed it.  They were now sure that he was dangerous and had always been dangerous. They talked about Tarasoff Duty to Warn and who should call the wife. I was surprised.  I thought my statement might make him seem less dangerous.

I have run into him a few times over the years. His wife remarried very soon after and always bad-mouthed him to the children after he was allowed contact again. He remarried five years later and eventually all the children came to live with him, as his ex-wife's new husband was rejecting of her children, favoring his own greatly. She became involved in a criminal matter years later. My patient still volunteered for scouts, his second wife ran an antiques store. He still seemed quiet and a bit odd, forty years later, but Google revealed nothing untoward. 

That's the best of the gut-trusting stories, but I have many others over the years. There were not many clinicians fully like that, but there were always a few, and others that showed soft signs of it. They came to resent me, as I was the one preparing the petitions to send over to legal, and would have to repeatedly tell them that we needed hard evidence. Very occasionally they would become quite upset, even losing their temper, blaming me that I just didn't know how to present these cases correctly and our legal team was incompetent. They would cite their years of training and many similar cases. They railed that the courts would not accept their professional opinion as sufficient for commitment. I noticed that the patients they worried about, mostly male or a female schizoid/schizotypal, just seemed odd and quiet to me. Over time, they left our system, as their clinical gut because less and less respected.

These clinicians were all women, though there were men among the nod-alongs. These women would deal with more overtly dangerous men all the time, even establishing some rapport with them.  But the spooky ones upset them at some deeper level. 

I have wondered if it is related to the phenomenon of abused and addicted women not being attracted to men that are a little weird, even though they know intellectually that they will be safer, provided for, and treated well by them. The weirdness is just too much for them, while the abuse is not. I suspect an evolutionary substrate to this, but don't trust the just-so stories I am making up about it. These days I wonder if this is bound up with the gut instincts of True Crime fans as well. 

Clearly, at least some people's gut instincts are not reliable, no matter how much they insist they are.