Thoughts Spurred by Malcolm Gladwell

At the suggestion of my dad, I read Malcolm Gladwell's books over the summer, and have some OT-related thoughts from them.

As a disclaimer, before someone jumps in to attack my lack of critical reading skills, I am well aware that none of the concepts in Gladwell's books are his own research, but there is a limit to how many individual research articles any one person is going to read in a given lifetime. So these are distilled stories with ready-made inferences, but interesting and thought provoking nonetheless. Here are some OT-related thoughts from the books The Tipping Point (TP), Blink (B), and Outliers (O).

Reading the Face (B 197) The final chapter of Blink discusses the work of Paul Ekman and ability to read emotions through expressions and micro-expressions. While I think it would be interesting to see when people are lying, frustrated, or scared, I think I would have better use to just be more aware of my own expressions and the message that I am subconsciously sending.

Fusiform vs Temporal gyrus (B 219)- After discussing visual tracking during a movie between persons w/ and w/o autism, he touches on a study indicating that most people picture and view faces using the fusiform gyrus. However, an autistic individual uses the inferior temporal gyrus to view faces, which is the same location that most people use only for objects. I wasn't really aware of that specific neurological difference but think that it would make an interesting principle to guide treatment.

10,000 hour rule (O 35)- This concept is presented as one of the precursors to mis-named overnight success. Several examples were given of people who started working in an unpopular field and had logged 10,000 hours of practice by the time that the field was ready for rapid growth. This number is referred to as the number of hours of practice needed to become an expert in the field. This would be a little over 5 years of full time work. How many OTs work their first 5 years uninterrupted, let alone in the same practice area? Just a thought. Also makes the hours needed for board and specialty certification seem almost doable.

Culture of Honor (O 161)- There was a mention of how a cultural importance of honor in highland areas has continued into the Appalachian region, giving some reasoning behind the number of feuds in the past century. This concept is also of high importance to many urban residents, especially in places where gang culture is rampant. I just thought it was an important tip to promote developing rapport with your clients and deferring to be more formal and respectful until you have a well developed relationship with your client and can be more informal.

Parenting styles (O 104)- A study is referenced that talks about 2 parenting styles: "concerted cultivation" vs "accomplishment of natural growth." I don't have full definitions for these, but they are associated with high and low SES families, respectively. The former is where the parent would encourage social skills and talent development through modeling and empowering the child. This was associated with higher confidence and better interactions with adults. The latter is a style that is more passive, leaving some of the development left up to teachers, coaches, therapists, etc. I definitely saw both types of parents when I was working with peds. In my experience, the latter style makes it hard to have home program carryover.

Levels of mitigation in speech (O 194)- The levels are restated here, and were discussed in the book in relation to studies about plane crashes. The author of that link also references an article from a person in a different power-index culture, which was interesting. I would be very interested to see a study on what terminology was used in ERs for trauma or in ICUs in critical moments between the various staff members. I may write up my observations on the language that is used at the interdisciplinary care meetings. But as far as client-therapist interactions, I think you have to balance your styles based on the client and family cultural and learning preferences. As an OT I want to give options, not take them away, however as safety concerns become larger, I do get more commanding.

Transactive Memory (TP 187) I scoured my in-depth books on cognition and found no mention of this concept, however, there is some research on this concept in the fields of relationship studies and also in computer science. This is where a couple or a group have certain tacitly designated tasks or things to remember. I never know where the various charger cords or electronic devices are, but/because my husband always does. This can happen sometimes in workplaces as well, where you have specialists and go-to guys/gals for specific tasks or theories. I think this also accounts for some of the memory impairment that I see in hospital patients as well. If you're used to sharing memory tasks it's not the same when you're out of your environment and out of touch with those you are close to.

The Tipping Point (TP 9)- Obviously this is the main idea of the first book, the idea that at some point change becomes unstoppable due to the momentous force behind it. My question here is- when is OT going to reach a tipping point? When are we going to be highly demanded in multiple fields? When are we going to be the go-to professionals for daily living, low vision, home mods, driving rehab, etc etc ad nauseum? When are we going to be respected by legislation, hospital policies, and other professions? I AM READY TO TIP! I know this is implicit in the Centennial Vision, and I would love for us as a profession to tip by that time. So I guess I'm still at the phase of tipping that I am becoming the best OT I can be so that when consumers have my services they come away with a great message about the purpose and power of OT. Just important to try your best every day since you don't know who you encounter that will be talking about you later.

Hope that's enough inspiration to help me get through the week! Anyone else have Gladwell-related thoughts?

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